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

Larson, Olivia

Office Address (Street, Box, or Route)

3555 Farnam St Suite 501

Permanent Residence (Street, Box, or Route)

4522 Woolworth Ave

City

Omaha

State

Zip

68131

City

Omaha

State

Zip

68106

Office Phone

(402) 999-8063

Home Phone

(402) 415-9158

Email Address

olarson@seeusrise.org

PRINCIPAL {49-1480(2)}

Name

RISE

Office Phone

(402) 999-8063

Office Address (Street, Box, or Route)

3555 Farnam Street, Suite 209

Official to Whom Lobbyist is Accountable

City

Omaha

State

Zip

68131

Nature of Business {49-1480(3)}

Nonprofit

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} criminal justice and voting rights related

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

Names and addresses of principal's officers:

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.

Olivia Larson

Lobbyist Name

Jan 3, 2024

Date