Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Nov 13, 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

Blomstedt, Matthew L.

Office Address (Street, Box, or Route)

455 S. 11th Street, Suite C

Permanent Residence (Street, Box, or Route)

3204 17th Ave

City

Lincoln

State

Zip

68508

City

Central City

State

Zip

68826

Office Phone

(402) 499-6756

Home Phone

Email Address

mblomstedt@nebraska.edu

PRINCIPAL {49-1480(2)}

Name

University of Nebraska

Office Phone

(402) 472-2111

Office Address (Street, Box, or Route)

3835 Holdrege Street

Official to Whom Lobbyist is Accountable

Jeffrey P. Gold

City

Lincoln

State

Zip

68583-0745

Nature of Business {49-1480(3)}

Education

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
112,000.00 Percentage of salary

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Higher Education Matters and Issues related to the University of Nebraska System

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

Names and addresses of principal's officers:

Jeffrey P. Gold - 3835 Holdrege Street - Lincoln, NE 68583-0745

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.

Matt Blomstedt

Lobbyist Name

Nov 13, 2024

Date