FORM
A-R
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Dec 20, 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)}

3601 Vincennes Road 

1000 Berkley Parkway, Apt. 236 

Indianapolis 

IN 

46268 

Kansas City 

KS 

64120 

(701) 202-8214 

(701) 202-8214 

compliance_ne_namic_1@multistate.us 

PRINCIPAL {49-1480(2)}

3601 Vincennes Road 

Jon Schnautz 

Indianapolis 

IN 

46268 

Insurance 

AMOUNTS GIVEN
2,000.00  Per Month  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Insurance  
Description of industry, trade, profession, or interests and groups represented by the principal:
Insurance 
Names and addresses of principal's officers:

Jon Schnautz
3601 Vincennes Road
Indianapolis, IN 46268

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:

None.

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

Ross Lien

Lobbyist Name

Dec 20, 2023

Date