Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Oct 9, 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

Kirk, Melanie

Office Address (Street, Box, or Route)

245 S 84th Suite 200

Permanent Residence (Street, Box, or Route)

245 S Cotner Blvd

City

Lincoln

State

Zip

68510

City

Lincoln

State

Zip

68510

Office Phone

(402) 937-1188

Home Phone

(402) 617-0685

Email Address

melaniek@nebraskacoalition.org

PRINCIPAL {49-1480(2)}

Name

Nebraska Domestic Violence Sexual Assault Coalition

Office Phone

(402) 476-6256

Office Address (Street, Box, or Route)

245 S 84th Street Suite 200

Official to Whom Lobbyist is Accountable

Christon MacTaggart

City

Lincoln

State

Zip

68510

Nature of Business {49-1480(3)}

Non-Profit Domestic Violence 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.
12,616.00 Per Year

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Matters which impact survivors of domestic violence, sexual assault and human trafficking in Nebraska

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

Names and addresses of principal's officers:

Nebraska Coalition to End Sexual and Domestic Violence Board of Directors: 245 S. 84th Street, Suite 200, Lincoln, NE 68510

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.

Melanie A Kirk

Lobbyist Name

Oct 9, 2024

Date