FORM
A-R
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Dec 12, 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)}

3255 Salt Creek Cir, Suite 100 

13618 Parker Circle  

Lincoln 

NE 

68504 

Omaha 

NE 

68154 

(402) 742-8140 

(402) 578-6442 

jnordquist@nebraskahospitals.org 

PRINCIPAL {49-1480(2)}

(402) 742-8140 

3255 Salt Creek Circle, Suite 100 

Self 

Lincoln 

NE 

68504 

Health 

AMOUNTS GIVEN
8,062.00  Per Month  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Health care related issues  
Description of industry, trade, profession, or interests and groups represented by the principal:
Hospital Industry 
Names and addresses of principal's officers:

Jeremy Nordquist, President
3255 Salt Creek Circle, Suite 100
Lincoln, NE 68504

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.

Jeremy Nordquist

Lobbyist Name

Dec 12, 2023

Date