Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 21, 2022

(This report is required to be filed on or before December 31 of each calendar year.)
49-1480.01(3)

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

Karbo, Michael

Office Address (Street, Box, or Route)

445 Minnesota Street, Suite 1500

Permanent Residence (Street, Box, or Route)

City

St. Paul

State

Zip

55101

City

State

Zip

Office Phone

(952) 220-9164

Home Phone

Email Address

karbom@api.org

PRINCIPAL {49-1480(2)}

Name

American Petroleum Institute

Office Phone

(202) 682-8000

Office Address (Street, Box, or Route)

200 Massachusetts Ave

Official to Whom Lobbyist is Accountable

Rolf Hanson

City

Washington

State

Zip

20005

Nature of Business {49-1480(3)}

Petroleum and Natural Gas

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
6,500.00 Per Year

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Issues pertaining to petroleum and natural gas

Description of industry, trade, profession, or interests and groups represented by the principal:
Trade association for petroleum and natural gas.

Names and addresses of principal's officers:

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.

karbom

Lobbyist Name

Dec 21, 2022

Date