FORM
A
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Jan 4, 2023
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) 328-3536 

5400 S. 16th Street 

Jarad Falk 

Lincoln 

NE 

68512 

Telecommunications 

AMOUNTS GIVEN
5,000.00  Per Month  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Telecommunications  
Description of industry, trade, profession, or interests and groups represented by the principal:
Telecommunications 
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.

Dustin Vaughan

Lobbyist Name

Jan 4, 2023

Date