Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 31, 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

Karges, Casey

Office Address (Street, Box, or Route)

PO Box 13

Permanent Residence (Street, Box, or Route)

City

Beatrice

State

Zip

68310

City

State

Zip

Office Phone

(402) 223-6061

Home Phone

Email Address

sschmidt@theresolutioncenter.org

PRINCIPAL {49-1480(2)}

Name

Nebraska Mediation Association

Office Phone

(402) 223-6061

Office Address (Street, Box, or Route)

PO Box 13

Official to Whom Lobbyist is Accountable

Kelly Riley, Director of Nebraska Mediat

City

Beatrice

State

Zip

68310

Nature of Business {49-1480(3)}

To promote and sustain quality conflict resolution

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)} Mediation and Restorative Justice Matters

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

Names and addresses of principal's officers:

List of Nebraska Mediation Association Board of Directors available on website (http://nemediation.org/who-we-are/staff.html)

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.

Karges, Casey

Lobbyist Name

Dec 31, 2019

Date