FORM
A-R
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Dec 31, 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.)

PLEASE FILL IN ALL BLANKS

LOBBYIST {49-1480(1)}

725 S 14th St 

 

Lincoln 

NE 

68508 

 

 

 

(402) 975-2195 

 

nancy@zulkoskiweber.com 

PRINCIPAL {49-1480(2)}

(515) 457-6099 

6400 Westown Parkway 

Jason Bassett 

West Des Moines 

IA 

50266 

Convenience Retailer 

AMOUNTS GIVEN
2,575.00  Per Month  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} All matters of interest to principal  
Description of industry, trade, profession, or interests and groups represented by the principal:
convenience retailer 
Names and addresses of principal's officers:

Kyle Krause, President & CEO, 6400 Westown Parkway, West Des Moines, IA 50266
Jason Bassett, Director of Government Relations, 6400 Westown Parkway, West Des Moines, IA 50266

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.

Zulkoski Weber LLC

Lobbyist Name

Dec 31, 2018

Date