Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 30, 2023

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

Black, David

Office Address (Street, Box, or Route)

1400 Douglas Street

Permanent Residence (Street, Box, or Route)

735 Riverfront Drive

City

Omaha

State

Zip

68179

City

Omaha

State

Zip

68102

Office Phone

(832) 381-4025

Home Phone

(832) 381-4025

Email Address

davidblack@up.com

PRINCIPAL {49-1480(2)}

Name

Union Pacific Railroad

Office Phone

(402) 544-3878

Office Address (Street, Box, or Route)

1400 Douglas Street STOP1560

Official to Whom Lobbyist is Accountable

City

Omaha

State

Zip

68179

Nature of Business {49-1480(3)}

Transportation

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

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

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

Names and addresses of principal's officers:

David Black
1400 Douglas Street
Omaha NE 68179

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.

David Black

Lobbyist Name

Dec 30, 2023

Date