Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Nov 19, 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

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

Lofquist, Kraig

Office Address (Street, Box, or Route)

6949 South 110th St

Permanent Residence (Street, Box, or Route)

9719 Chateau Circle

City

LaVista

State

Zip

68128

City

Lincoln

State

Zip

68526

Office Phone

(402) 597-4915

Home Phone

(402) 953-8456

Email Address

esuccadmin@esucc.org

PRINCIPAL {49-1480(2)}

Name

Educational Service Unit Coordinating Council

Office Phone

(402) 597-4915

Office Address (Street, Box, or Route)

6949 So. 110th Street

Official to Whom Lobbyist is Accountable

ESUCC

City

LaVista

State

Zip

68128

Nature of Business {49-1480(3)}

Educational

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
4,687.50 Per Quarter

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

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

Names and addresses of principal's officers:

Educational Service Unit Coordinating Council, 6949 south 110th Street, LaVista NE 68128

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.

Lofquist, Kraig

Lobbyist Name

Nov 19, 2019

Date