Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 6, 2023

(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

Haugaard, Treva

Office Address (Street, Box, or Route)

1036 Bruin Blvd Ste 110

Permanent Residence (Street, Box, or Route)

4940 S 114th Street, Suite 5

City

Bellevue

State

Zip

68005

City

Omaha

State

Zip

68137

Office Phone

(402) 339-1660

Home Phone

(402) 881-6319

Email Address

connie@cincfoundation.org

PRINCIPAL {49-1480(2)}

Name

Council of Independent Nebraska Colleges

Office Phone

(402) 339-1660

Office Address (Street, Box, or Route)

1036 Bruin Blvd., Suite 110

Official to Whom Lobbyist is Accountable

Dr. Mary Hawkins

City

Bellevue

State

Zip

68005

Nature of Business {49-1480(3)}

Postsecondary education

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
1,000.00 Per Month

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Issues impacting private postsecondary institutions

Description of industry, trade, profession, or interests and groups represented by the principal:
Association of private colleges and universities

Names and addresses of principal's officers:

CINC President
Dr. Mary Hawkins
Address same as above

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.

THaugaard

Lobbyist Name

Dec 6, 2023

Date