Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Feb 20, 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

Kaffenberger, Holly

Office Address (Street, Box, or Route)

PO Box 24168

Permanent Residence (Street, Box, or Route)

5319 Boyd Street

City

Omaha

State

Zip

68124

City

Omaha

State

Zip

68104

Office Phone

(402) 507-5502

Home Phone

(402) 676-7064

Email Address

holly.kaffenberger@cancer.org

PRINCIPAL {49-1480(2)}

Name

American Cancer Society Cancer Action Network

Office Phone

(816) 527-8625

Office Address (Street, Box, or Route)

PO Box 24168

Official to Whom Lobbyist is Accountable

Megan Word

City

Omaha

State

Zip

68124

Nature of Business {49-1480(3)}

Charity

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Matters associated with health and wellness including tobacco control, Medicaid access to health care and cancer prevention.

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

Names and addresses of principal's officers:

Lisa Lacasse, President
655 15th Street NW, Suite 503
Washington, D.C. 20005

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.

Holly Kaffenberger

Lobbyist Name

Feb 20, 2024

Date