FORM
A
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Jan 22, 2024
Amended Registration
Lobbyist Registration Fee:
{49-1480.01}

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

301 S. 13th Street, Suite 400 

 

Lincoln 

NE 

68508 

 

NE 

 

(402) 476-1188 

 

jkohout@kisselkohoutes.com 

PRINCIPAL {49-1480(2)}

(972) 391-5390 

14185 Dallas Parkway, Suite 300 

Mark Binder 

Dallas 

TX 

75254 

Automobile Company 

AMOUNTS GIVEN
3,000.00  Per Month  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Issues as directed by the client  
Description of industry, trade, profession, or interests and groups represented by the principal:
 
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:

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

Kissel, Kohout, ES Associates

Lobbyist Name

Jan 22, 2024

Date