Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 23, 2024

(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

$300.00

(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

Lee-Chambers, Gayla

Office Address (Street, Box, or Route)

4401 north 21 Street

Permanent Residence (Street, Box, or Route)

5421 South 33 street

City

omaha

State

Zip

68110

City

omaha

State

Zip

68107

Office Phone

(402) 451-5549

Home Phone

Email Address

corporateoffices4401@gmail.com

PRINCIPAL {49-1480(2)}

Name

Together We Achieve Miracles Inc - Ernie Chambers History-Arts-Humanities Museum

Office Phone

(402) 451-5549

Office Address (Street, Box, or Route)

4401 North 21 Street

Official to Whom Lobbyist is Accountable

4401 north 21 Street

City

Omaha

State

Zip

68110

Nature of Business {49-1480(3)}

on behalf of Ernie Chambers legacy

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

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

Description of industry, trade, profession, or interests and groups represented by the principal:
Ernie Chambers legacy

Names and addresses of principal's officers:

Together We Achieve Miracles Inc 4401 north 21 Street Omaha Ne 68110

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.

TWAM

Lobbyist Name

Dec 23, 2024

Date