Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Apr 19, 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

Dennis, Tommy

Office Address (Street, Box, or Route)

6220 Maple St

Permanent Residence (Street, Box, or Route)

2907 Bristol St

City

Omaha

State

Zip

68104

City

Omaha

State

Zip

68111

Office Phone

(402) 552-9260, Ext. 122

Home Phone

(402) 213-3696

Email Address

tdennis1987@gmail.com

PRINCIPAL {49-1480(2)}

Name

Nebraska AIDS Project

Office Phone

(402) 552-9260

Office Address (Street, Box, or Route)

6220 Maple St

Official to Whom Lobbyist is Accountable

Brent Koster

City

Omaha

State

Zip

68104

Nature of Business {49-1480(3)}

Non-profit

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
8,994.00 Percentage of salary

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} LGBTQIA Issues, Public Health, Human rights

Description of industry, trade, profession, or interests and groups represented by the principal:
Non profit AIDS Service Organization

Names and addresses of principal's officers:

Brent Koster 6220 Maple St Omaha NE 68104

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.

Tommy Dennis

Lobbyist Name

Apr 19, 2024

Date