FORM
A-R
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Nov 15, 2023

(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)}

6910 Pacific Street, Suite 216 

 

Omaha 

NE 

68106 

 

 

 

(402) 452-3737 

 

jsmith@platteinstitute.org 

PRINCIPAL {49-1480(2)}

(402) 452-3737 

6910 Pacific Street, Suite 216 

 

Omaha 

NE 

68106 

Policy Research 

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

Jim Smith

Lobbyist Name

Nov 15, 2023

Date