FORM
A-R
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Nov 18, 2019

(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)}

8200 Dodge Street 

4206 N. 191 Street 

Omaha 

NE 

68114 

Elkhorn 

NE 

68022 

(402) 955-4139 

(402) 216-5302 

cheyen@peetzco.com 

PRINCIPAL {49-1480(2)}

(402) 955-4139 

8200 Dodge Street 

Dr. Azizkhan 

Omaha 

NE 

68114 

Health care 

AMOUNTS GIVEN
4,700.00  Per Quarter  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Any and all matters important to the client  
Description of industry, trade, profession, or interests and groups represented by the principal:
Health care 
Names and addresses of principal's officers:

Dr. Richard Azizkhan
8200 Dodge Street
Omaha, NE 68114

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.

Lyons, Liz

Lobbyist Name

Nov 18, 2019

Date