Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 6, 2019

(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

Koops, Berend

Office Address (Street, Box, or Route)

c/o Nielsen Merksamer et al., 2350 Kerner Blvd., Suite 250

Permanent Residence (Street, Box, or Route)

N/A

City

San Rafael

State

Zip

94901

City

State

Zip

Office Phone

(415) 389-6800

Home Phone

Email Address

berend_koops@merck.com; jkaune@nmgovlaw.com

PRINCIPAL {49-1480(2)}

Name

Merck Sharp and Dohme Corp.

Office Phone

(415) 389-6800

Office Address (Street, Box, or Route)

c/o Nielsen Merksamer et al., 2350 Kerner Blvd., Suite 250

Official to Whom Lobbyist is Accountable

Steve Lucas

City

San Rafael

State

Zip

94901

Nature of Business {49-1480(3)}

Health

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
2,000.00 Per Month

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Matters relating to general business, animal and human health, pharmaceutical and vaccine issues

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

Names and addresses of principal's officers:

Kenneth C. Frazier
2000 Galloping Hill Road
Kenilworth, NJ 07033

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)}

None listed

I certify that all information presented in this form is accurate to the best of my knowledge.

Koops, Berend

Lobbyist Name

Dec 6, 2019

Date