Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Apr 23, 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

Holman, Matthew

Office Address (Street, Box, or Route)

501 S 13th St

Permanent Residence (Street, Box, or Route)

2501 Clayton Ct

City

Lincoln

State

Zip

68508

City

Lincoln

State

Zip

68507

Office Phone

(531) 278-5916

Home Phone

(402) 601-8408

Email Address

mholman@fmne.com

PRINCIPAL {49-1480(2)}

Name

Farmers Mutual of Nebraska

Office Phone

(402) 434-8300

Office Address (Street, Box, or Route)

501 S. 13th St.

Official to Whom Lobbyist is Accountable

Ann Parr

City

Lincoln

State

Zip

68508

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.
4,000.00 Per Quarter

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Insurance, general business matters

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

Names and addresses of principal's officers:

Gayle Page, President 501 S 13th St, Lincoln, NE 68508
Mark Walz, CEO and Chairman 501 S 13th St, Lincoln, NE 68508

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.

mattholman

Lobbyist Name

Apr 23, 2025

Date