Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Apr 19, 2024

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

Coffey, Chase

Office Address (Street, Box, or Route)

284 Highland Parkway

Permanent Residence (Street, Box, or Route)

284 Highland Parkway

City

Frankfort

State

Zip

40601

City

Frankfort

State

Zip

40601

Office Phone

(502) 395-1930

Home Phone

(502) 395-1930

Email Address

ccoffey@collegeboard.org

PRINCIPAL {49-1480(2)}

Name

College Board

Office Phone

(202) 741-4799

Office Address (Street, Box, or Route)

1919 M St NW

Official to Whom Lobbyist is Accountable

City

Washington

State

Zip

20009

Nature of Business {49-1480(3)}

Education

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

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

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

Names and addresses of principal's officers:

Michelle Arnold,
1919 M St NW, Washington DC 20009

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.

Chase David Coffey

Lobbyist Name

Apr 19, 2024

Date