Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Jan 2, 2024

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

Tripple, Todd

Office Address (Street, Box, or Route)

5606 South 147th Street

Permanent Residence (Street, Box, or Route)

17450 Archer Circle

City

Omaha

State

Zip

68135

City

Omaha

State

Zip

68135

Office Phone

(402) 715-8338

Home Phone

(402) 677-6291

Email Address

tetripple@mpsomaha.org

PRINCIPAL {49-1480(2)}

Name

Millard Public Schools

Office Phone

(402) 715-8206

Office Address (Street, Box, or Route)

5606 S. 147th Street

Official to Whom Lobbyist is Accountable

Millard Public Schools

City

Omaha

State

Zip

68137

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.
5,073.00 Per Quarter

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Education

Description of industry, trade, profession, or interests and groups represented by the principal:
Education

Names and addresses of principal's officers:

Millard Public Schools
5606 S. 147th Street
Omaha, NE 68135

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.

Todd Tripple

Lobbyist Name

Jan 2, 2024

Date