Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 23, 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

Kubat, Rick

Office Address (Street, Box, or Route)

1723 Harney Street

Permanent Residence (Street, Box, or Route)

8222 Castelar

City

Omaha

State

Zip

68102

City

Omaha

State

Zip

68124

Office Phone

(402) 504-7125

Home Phone

(402) 598-7456

Email Address

rick_kubat@mudnebr.com

PRINCIPAL {49-1480(2)}

Name

Metropolitan Utilities District

Office Phone

(402) 504-7125

Office Address (Street, Box, or Route)

1723 Harney Street

Official to Whom Lobbyist is Accountable

City

Omaha

State

Zip

68102

Nature of Business {49-1480(3)}

gas and water utility

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} all matters related to the Metropolitan Utilities District of Omaha

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

Names and addresses of principal's officers:

Metropolitan Utilities District of Omaha 1723 Harney Street, Omaha Ne 68102

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

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

Kubat, Rick

Lobbyist Name

Dec 23, 2019

Date