Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Jan 3, 2023

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

Hill, Justin

Office Address (Street, Box, or Route)

405 5th Ave. South, Suite 7

Permanent Residence (Street, Box, or Route)

3574 Quiet Dr

City

Naples

State

Zip

34102

City

Sarasota

State

Zip

34240

Office Phone

(636) 541-1776

Home Phone

(636) 541-1776

Email Address

jshill271

PRINCIPAL {49-1480(2)}

Name

Binti, Inc.

Office Phone

(415) 903-2800

Office Address (Street, Box, or Route)

1212 Broadway, Suite 200

Official to Whom Lobbyist is Accountable

Erin Lama - Politicom Law

City

Oakland

State

Zip

94612

Nature of Business {49-1480(3)}

IT Services

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
15,660.00 Per Month

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

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

Names and addresses of principal's officers:

Felicia Curcuru CEO - 1212 Broadway, Suite 200, Oakland CA 94612

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.

Justin Hill

Lobbyist Name

Jan 3, 2023

Date