Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Jan 31, 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

Geilenfeld, Rachel

Office Address (Street, Box, or Route)

c/o 2350 Kerner Blvd., Ste 250

Permanent Residence (Street, Box, or Route)

4004 NE Timber Lane

City

San Rafael

State

Zip

94901

City

Ankeny

State

Zip

50021

Office Phone

(415) 389-6800

Home Phone

(415) 389-6800

Email Address

chevron1@nmgovlaw.com

PRINCIPAL {49-1480(2)}

Name

Chevron U.S.A. 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

James W. Carson

City

San Rafael

State

Zip

94901

Nature of Business {49-1480(3)}

Energy

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

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

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

Names and addresses of principal's officers:

James W. Carson - c/o 2350 Kerner Blvd., Ste. 250, San Rafael, CA 94901

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.

Rachel Geilenfeld

Lobbyist Name

Jan 31, 2024

Date