FORM
A-R
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Dec 27, 2018

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

Amended Registration
Lobbyist Registration Fee:
{49-1480.01}

(If you are a salaried employee of your principal, you are a compensated lobbyist.)
(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)}

635 S 14th Suite 315 

 

Lincoln 

NE 

68508 

 

NE 

 

(402) 327-1603 

 

Bromm Nielsen & Mines 

PRINCIPAL {49-1480(2)}

(307) 358-6541 

PO Box 1210 

Brent Berg 

Glenrock 

WY 

82637 

Uranium mining 

AMOUNTS GIVEN
10,000.00  Per Year  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} All matters of interest to the principal  
Description of industry, trade, profession, or interests and groups represented by the principal:
 
Names and addresses of principal's officers:

Brent Berg. 505 Poplar Street, Suite 100, Casper, Wyoming 82601

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:

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

Bromm Nielsen & Mines

Lobbyist Name

Dec 27, 2018

Date