Nebraska Legislature - Lobbyist Reporting Application

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Jan 28, 2019 - 9:51 PM

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Jan 28, 2019

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
Date Amended: Jan 28, 2019

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

Bland, Jaime

Office Address (Street, Box, or Route)

Po Box 27842

Permanent Residence (Street, Box, or Route)

City

Omaha

State

Zip

68127

City

Omaha

State

Zip

68127

Office Phone

(402) 506-9900, Ext. 125

Home Phone

(402) 506-9900, Ext. 125

Email Address

jbland@nehii.org

PRINCIPAL {49-1480(2)}

Name

Nebraska Health Information Initiative, Inc.

Office Phone

(402) 506-9900

Office Address (Street, Box, or Route)

PO Box 27842

Official to Whom Lobbyist is Accountable

Michael White, MD- NEHII Board Chair

City

Omaha

State

Zip

68127

Nature of Business {49-1480(3)}

health information exchange

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} health information exchange, health information and prescription drug monitoring

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

Names and addresses of principal's officers:

Michael White. MD NEHII Board Chair PO Box 27842 Omaha, NE 68127

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)}

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

Bland, Jaime

Lobbyist Name

Jan 28, 2019

Date