Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Jan 3, 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

Amack, Angela K.

Office Address (Street, Box, or Route)

625 S. 14th Street, Ste B

Permanent Residence (Street, Box, or Route)

1512 Skyline Drive

City

Lincoln

State

Zip

68508

City

Lincoln

State

Zip

68506

Office Phone

(402) 430-1869

Home Phone

(402) 430-1869

Email Address

angelaamack@gmail.com

PRINCIPAL {49-1480(2)}

Name

Nebraska Professional Fire Fighters Association (NPFFA)

Office Phone

(402) 770-5547

Office Address (Street, Box, or Route)

241 Victory Lane

Official to Whom Lobbyist is Accountable

Gary Bruns

City

Lincoln

State

Zip

68528

Nature of Business {49-1480(3)}

Public Safety

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
24,000.00 Per Year

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Matters related to public safety and career firefighters.

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

Names and addresses of principal's officers:

Gary Bruns

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)}

None

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

Angela Amack

Lobbyist Name

Jan 3, 2024

Date