Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 31, 2023

Clerk of the Legislature
Room 2014, State Capitol
PO Box 94604
Lincoln, NE 68509-4604
Phone: (402) 471-2608

For Calendar Year of:

Amended Registration

Lobbyist Registration Fee:
{49-1480.01}

Compensated

$200.00

(If you are a salaried employee of your principal, you are a compensated lobbyist.)

Not Compensated

$15.00

(File a Form E for quarterly report exemption. You are not exempt from the Form D Activity Report.)

PLEASE FILL IN ALL BLANKS

LOBBYIST {49-1480(1)}

Name

Splonskowski, David

Office Address (Street, Box, or Route)

PO Box 57041

Permanent Residence (Street, Box, or Route)

906 S 2nd St

City

Lincoln

State

Zip

68505

City

Plattsmouth

State

Zip

68048

Office Phone

(402) 423-4297

Home Phone

(402) 423-4297

Email Address

swift.key9890@fastmail.com

PRINCIPAL {49-1480(2)}

Name

Nebraska Christian Home Educators Association

Office Phone

(402) 423-4297

Office Address (Street, Box, or Route)

PO Box 57041

Official to Whom Lobbyist is Accountable

Robin Gould

City

Lincoln

State

Zip

68505

Nature of Business {49-1480(3)}

Education

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
0.00 Per Month

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Laws, legislation, and regulations affecting and/or potentially affecting exempt home education.

Description of industry, trade, profession, or interests and groups represented by the principal:
Freedom for home educators in Nebraska

Names and addresses of principal's officers:

Robin Gould - 1655 Harwood St, Lincoln, NE 68502-2721
Jeff Bennet - 2408 S 18th St, Lincoln, NE 68502-3721
Nick Lenzen - 2610 Winchester S, Lincoln, NE 68512-1656
David Splonskowski – 906 S 2nd St, Plattsmouth, NE 68048

GIVE NAME and ADDRESS of any OFFICIAL in the Legislative or Executive Branch and of any members of any such official's staff or immediate family who is employed by you or by anyone acting on your behalf: {49-1480(8)}

I certify that all information presented in this form is accurate to the best of my knowledge.

David Splonskowski

Lobbyist Name

Dec 31, 2023

Date