Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Jan 17, 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

Husch Blackwell Strategies

Office Address (Street, Box, or Route)

1630 K Street

Permanent Residence (Street, Box, or Route)

City

Lincoln

State

Zip

68508

City

State

Zip

Office Phone

(402) 434-8040

Home Phone

Email Address

rmallett@hbstrategies.us

PRINCIPAL {49-1480(2)}

Name

ACT, Inc.

Office Phone

(415) 389-6800

Office Address (Street, Box, or Route)

c/o 2350 Kerner Blvd., Ste. 250

Official to Whom Lobbyist is Accountable

Mary LeFebvre

City

San Rafael

State

Zip

94901

Nature of Business {49-1480(3)}

Assessments

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
5,000.00 Per Month

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

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

Names and addresses of principal's officers:

Mary LeFebvre, 500 ACT Drive, Iowa City, IA 52243

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.

Dustin Vaughan

Lobbyist Name

Jan 17, 2024

Date