Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Oct 23, 2018

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

Grisham, Kent

Office Address (Street, Box, or Route)

1701 K Street

Permanent Residence (Street, Box, or Route)

1701 K Street

City

Lincoln

State

Zip

68509

City

Lincoln

State

Zip

68509

Office Phone

(402) 476-8504

Home Phone

Email Address

kent@nebtrucking.com

PRINCIPAL {49-1480(2)}

Name

Nebraska Trucking Association

Office Phone

(402) 476-8504

Office Address (Street, Box, or Route)

1701 K Street

Official to Whom Lobbyist is Accountable

Board of Directors

City

Lincoln

State

Zip

68508

Nature of Business {49-1480(3)}

Trade Association

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
105,000.00 Per Year

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Transportation, Trucking, Infrastructure (Roads & Highways), Business and Tax Matters

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

Names and addresses of principal's officers:

Nebraska Trucking Association
1701 K Street
Lincoln, NE 68509

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.

Grisham, Kent

Lobbyist Name

Oct 23, 2018

Date