Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 7, 2018

(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

PLEASE FILL IN ALL BLANKS

LOBBYIST {49-1480(1)}

Name

Bottorf, Wesley

Office Address (Street, Box, or Route)

501 S. 13th Street

Permanent Residence (Street, Box, or Route)

8025 S. 36th Street

City

Lincoln

State

Zip

68508

City

Lincoln

State

Zip

68516

Office Phone

(402) 473-5849

Home Phone

(402) 984-7026

Email Address

wbottorf@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

Mark Walz

City

Lincoln

State

Zip

68501

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 Related

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

Names and addresses of principal's officers:

Mark Walz - President 501 S. 13th Street, Lincoln, NE 68508
Ann Parr - Senior VP 501 S. 13th Street, 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)}

None

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

Bottorf, Wesley

Lobbyist Name

Dec 7, 2018

Date