Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Oct 24, 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

Swanson, Heather

Office Address (Street, Box, or Route)

875 Kyner Road

Permanent Residence (Street, Box, or Route)

same as office

City

Long Pine

State

Zip

69217

City

State

Zip

Office Phone

(308) 830-1435

Home Phone

Email Address

heathersuzette@gmail.com

PRINCIPAL {49-1480(2)}

Name

Nebraska Affiliate of the American College of Nurse-Midwives

Office Phone

(402) 484-1210

Office Address (Street, Box, or Route)

PO Box 343

Official to Whom Lobbyist is Accountable

Libby Mollard/President

City

Long Pine

State

Zip

69217

Nature of Business {49-1480(3)}

Professional Org for Certified Nurse-Midwives

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} On the profession of Certified Nurse-Midwifery

Description of industry, trade, profession, or interests and groups represented by the principal:
Certified Nurse-Midwifery

Names and addresses of principal's officers:

Libby Mollard
4900 Brindle Lane
Lincoln NE 68516

Latrice Martin
11707 S 114th Ave
Papillion NE 68046

Jill Dolberg
1025 Larkspur Dr
Hickman NE 68372

Heather Swanson
875 N Kyner Road
Long Pine NE 69217

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)}

N/A

I certify that all information presented in this form is accurate to the best of my knowledge.

Heather Swanson

Lobbyist Name

Oct 24, 2024

Date