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

Burkhardt, Carly

Office Address (Street, Box, or Route)

1630 K Street

Permanent Residence (Street, Box, or Route)

416 S 150th Cir

City

Lincoln

State

Zip

68508

City

Omaha

State

Zip

68154

Office Phone

Home Phone

Email Address

cburkhardt@hbstrategies.us

PRINCIPAL {49-1480(2)}

Name

Husch Blackwell Strategies LLC

Office Phone

(402) 434-8040

Office Address (Street, Box, or Route)

1630 K Street

Official to Whom Lobbyist is Accountable

Husch Blackwell Strategies LLC

City

Lincoln

State

Zip

68508

Nature of Business {49-1480(3)}

public affairs

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
15,000.00 Per Quarter

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} all bills, amendments, and matters of interest to identified client list of Husch Blackwell Strategies

Description of industry, trade, profession, or interests and groups represented by the principal:
lobbying and consulting

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: {49-1480(8)}

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

Carly Burkhardt

Lobbyist Name

Dec 6, 2023

Date