Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Nov 1, 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

Hausman, Adam

Office Address (Street, Box, or Route)

1503 Lakeshore Dr.

Permanent Residence (Street, Box, or Route)

1503 Lakeshore Dr.

City

Beatrice

State

Zip

68310

City

Beatrice

State

Zip

68310

Office Phone

(402) 239-0846

Home Phone

(402) 239-0846

Email Address

Hausman3638@hotmail.com

PRINCIPAL {49-1480(2)}

Name

Nebraska State Legislative Board - Brotherhood of Locomotive Engineers and Trainmen

Office Phone

(402) 239-0846

Office Address (Street, Box, or Route)

1503 Lakeshore Dr.

Official to Whom Lobbyist is Accountable

Adam Hausman

City

Beatrice

State

Zip

68310

Nature of Business {49-1480(3)}

Union

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Railroad Safety

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

Names and addresses of principal's officers:

Adam Hausman 1503 Lakeshore Dr. Beatrice NE, 68310

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.

Adam Hausman

Lobbyist Name

Nov 1, 2024

Date