Nebraska Legislature - Lobbyist Reporting Application

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)

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

Baird Holm LLP

Office Address (Street, Box, or Route)

1700 Farnam Street, Suite 1500

Permanent Residence (Street, Box, or Route)

City

Omaha

State

Zip

68102

City

State

Zip

Office Phone

(402) 636-8310

Home Phone

Email Address

dlevy@bairdholm.com

PRINCIPAL {49-1480(2)}

Name

Northeast Power

Office Phone

(800) 750-9277

Office Address (Street, Box, or Route)

1410 W 7th St.

Official to Whom Lobbyist is Accountable

Mark Shults

City

Wayne

State

Zip

68787

Nature of Business {49-1480(3)}

ENERGY

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
2,000.00 Per Month

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

Description of industry, trade, profession, or interests and groups represented by the principal:
PROVIDER OF ELECTRICITY

Names and addresses of principal's officers:

Don Larsen, President, 1410 W. 7th St., Wayne, NE 68787
Paul Bodlak, Vice President, 1410 W. 7th St., Wayne, NE 68787

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.

Baird Holm LLP

Lobbyist Name

Dec 27, 2018

Date