Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 26, 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

Catalyst Public Affairs

Office Address (Street, Box, or Route)

301 South 13th Street, Suite 402

Permanent Residence (Street, Box, or Route)

City

Lincoln

State

Zip

68508

City

State

Zip

Office Phone

(402) 261-5293

Home Phone

Email Address

tgay@catalystnebraska.com

PRINCIPAL {49-1480(2)}

Name

Jobs for America's Graduates Nebraska

Office Phone

(402) 342-8232

Office Address (Street, Box, or Route)

2201 Farnam Street

Official to Whom Lobbyist is Accountable

Shawna Forsberg

City

Omaha

State

Zip

68102

Nature of Business {49-1480(3)}

Nonprofit

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
7,500.00 Bi-Annually

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} workforce development, education

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

Names and addresses of principal's officers:

Shawna Forsberg
President and CEO
United Way of the Midlands
2201 Farnam Street, Suite 200
Omaha, NE 68102

Matt Wallen
Senior Vice President, Community Impact and Analytics
United Way of the Midlands
402-522-7950

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.

Catalyst Public Affairs, Inc.

Lobbyist Name

Dec 26, 2023

Date