Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Apr 10, 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

Wayne, Justin

Office Address (Street, Box, or Route)

PO Box 265

Permanent Residence (Street, Box, or Route)

8937 North 56th Ave. Cir.

City

Omaha

State

Zip

68102

City

Omaha

State

Zip

68152

Office Phone

(402) 933-6603

Home Phone

Email Address

justin@justinwaynelaw.com

PRINCIPAL {49-1480(2)}

Name

Nebraska Democratic Party

Office Phone

(402) 434-2180

Office Address (Street, Box, or Route)

421 S 9th St, Suite 233

Official to Whom Lobbyist is Accountable

Jane Kelleb

City

Lincoln

State

Zip

68508

Nature of Business {49-1480(3)}

Political Party

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 Year

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

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

Names and addresses of principal's officers:

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.

Justin T. Wayne

Lobbyist Name

Apr 10, 2025

Date