FORM
A-R
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Dec 28, 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)}

625 S. 14th Street, Suite A 

625 S 14th Street, Suite A 

Lincoln 

NE 

68508 

Lincoln 

NE 

68508 

(402) 436-2165 

(402) 436-2165 

kent@jensenrogert.com 

PRINCIPAL {49-1480(2)}

(402) 826-8333 

1014 Boswell Ave 

Derek Bierman 

Crete 

NE 

68333 

Post-secondary education 

AMOUNTS GIVEN
30,000.00  Per Year  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Higher Education and Issues related to Doane University  
Description of industry, trade, profession, or interests and groups represented by the principal:
Post-secondary education 
Names and addresses of principal's officers:

Derek Bierman, Chief Information Officer, Doane University, 1014 Boswell Ave, Crete NE 68333

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.

JensenRogertAssocInc

Lobbyist Name

Dec 28, 2023

Date