Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 27, 2017

(This report is required to be filed on or before December 31 of each calendar year.)
49-1480.01(3)

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

$200.00

(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

Davidson Tribbs, Emma

Office Address (Street, Box, or Route)

PO Box 4184

Permanent Residence (Street, Box, or Route)

PO Box 4184

City

New York

State

Zip

10163

City

New York

State

Zip

10163

Office Phone

(646) 324-8250

Home Phone

Email Address

lobbyreg@everytown.org

PRINCIPAL {49-1480(2)}

Name

Everytown for Gun Safety Action Fund

Office Phone

(646) 324-8250

Office Address (Street, Box, or Route)

PO Box 4184

Official to Whom Lobbyist is Accountable

Tara Paone

City

New York

State

Zip

10163

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.
5.00 Percentage of salary

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

Description of industry, trade, profession, or interests and groups represented by the principal:
Gun violence prevention

Names and addresses of principal's officers:

Richard DeScherer - Chair
John Feinblatt - President
Diane Gubelli - Secretary and Treasurer
PO Box 4184
New York, NY 10163

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)}

N/A

I certify that all information presented in this form is accurate to the best of my knowledge.

Davidson Tribbs, Emma

Lobbyist Name

Dec 27, 2017

Date