Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 12, 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

(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

Baratta, Robert

Office Address (Street, Box, or Route)

50 Pear Street

Permanent Residence (Street, Box, or Route)

50 Pear Street

City

Richmond

State

Zip

23223

City

Richmond

State

Zip

23223

Office Phone

(804) 771-5309

Home Phone

(804) 771-5309

Email Address

teladoc@politicomlaw.com

PRINCIPAL {49-1480(2)}

Name

Teladoc Inc.

Office Phone

(415) 903-2800

Office Address (Street, Box, or Route)

c/o 28 Liberty Ship Way, Suite 2815

Official to Whom Lobbyist is Accountable

Darrin Lim

City

Sausalito

State

Zip

94965

Nature of Business {49-1480(3)}

Telehealth Services

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

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

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

Names and addresses of principal's officers:

Claudia Tucker, 2 Manhattanville Rd., Purchase, NY 10577

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.

Baratta, Robert

Lobbyist Name

Dec 12, 2018

Date