Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 31, 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

PLEASE FILL IN ALL BLANKS

LOBBYIST {49-1480(1)}

Name

Lawrence, Katherine

Office Address (Street, Box, or Route)

c/o 2350 Kerner Blvd., Ste. 250

Permanent Residence (Street, Box, or Route)

500 ACT Drive

City

San Rafael

State

Zip

94901

City

Iowa City

State

Zip

52243-0168

Office Phone

(415) 389-6800

Home Phone

Email Address

actinc3@nmgovlaw.com

PRINCIPAL {49-1480(2)}

Name

ACT, Inc.

Office Phone

(415) 389-6800

Office Address (Street, Box, or Route)

c/o 2350 Kerner Blvd., Ste. 250

Official to Whom Lobbyist is Accountable

Evann Whitelam

City

San Rafael

State

Zip

94901

Nature of Business {49-1480(3)}

Education and workforce development solutions.

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
7,000.00 Per Year

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Matters affecting education and workforce development.

Description of industry, trade, profession, or interests and groups represented by the principal:
Matters affecting education and workforce development solutions.

Names and addresses of principal's officers:

Marten Roorda, CEO: 500 ACT Drive, Iowa City, IA 52243, Janet Godwin, COO: 500 ACT Drive, Iowa City, IA 52243, Santonu Jana, CFO: 500 ACT Drive, Iowa City, IA 52243

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.

Lawrence, Katherine

Lobbyist Name

Dec 31, 2019

Date