Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Jan 9, 2025

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

Mueller Robak

Office Address (Street, Box, or Route)

530 S. 13th Street, Suite 110

Permanent Residence (Street, Box, or Route)

City

Lincoln

State

Zip

68508

City

State

Zip

Office Phone

(402) 434-3399

Home Phone

Email Address

caitlin@muellerrobak.com

PRINCIPAL {49-1480(2)}

Name

Nationwide Mutual Insurance Company

Office Phone

(503) 312-4439

Office Address (Street, Box, or Route)

One Nationwide Plaza, CO-60-ELIZ

Official to Whom Lobbyist is Accountable

Melissa Crawford

City

Columbus

State

Zip

43215

Nature of Business {49-1480(3)}

Insurance

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
5,000.00 Per Month

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

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

Names and addresses of principal's officers:

Anne Saxon, Vice President, State Government Relations, One Nationwide Plaza, Columbus, OH 43215

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.

Mueller Robak LLC

Lobbyist Name

Jan 9, 2025

Date