FORM
A-R
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Dec 23, 2022

(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.)
(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)}

1327 H Street 

 

Lincoln 

NE 

68508 

 

 

 

(402) 434-8040 

 

rmallett@hbstrategies.us 

PRINCIPAL {49-1480(2)}

(402) 982-7000 

1919 Aksarben Drive 

Jeremiah Blake 

Omaha 

NE 

68180 

Insurance 

AMOUNTS GIVEN
3,000.00  Per Month  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Any and all matters relating to health insurance, general business issues  
Description of industry, trade, profession, or interests and groups represented by the principal:
Health Insurance 
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:

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

HBS1

Lobbyist Name

Dec 23, 2022

Date