Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Jul 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

$300.00

(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

Nicely, Fredrick

Office Address (Street, Box, or Route)

122 C St NW

Permanent Residence (Street, Box, or Route)

4161 Columbus Rd

City

Washington

State

Zip

20001

City

Wooster

State

Zip

44691

Office Phone

(202) 484-5213

Home Phone

(614) 354-2443

Email Address

fnicely@cost.org

PRINCIPAL {49-1480(2)}

Name

Council On State Taxation

Office Phone

(202) 484-5213

Office Address (Street, Box, or Route)

122 C St NW

Official to Whom Lobbyist is Accountable

Pat Reynolds

City

Washington

State

Zip

20001

Nature of Business {49-1480(3)}

Trade Organization

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
1,000.00 Per Month

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} State and local taxes

Description of industry, trade, profession, or interests and groups represented by the principal:
501(c)6 Trade Organization

Names and addresses of principal's officers:

Mike Carchia - Chair of the Board
Pat Reynolds - President of the Board

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.

Fredrick Nicely

Lobbyist Name

Jul 31, 2024

Date