Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 31, 2019

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

Moulton, MaryLee

Office Address (Street, Box, or Route)

LWVNE, 4600 Valley Rd., Suite 306

Permanent Residence (Street, Box, or Route)

2035 S 181st Cir

City

Lincoln

State

Zip

68510

City

Omaha

State

Zip

68130-2779

Office Phone

(402) 475-1411

Home Phone

(520) 990-5944

Email Address

marylee@lwvgo.org

PRINCIPAL {49-1480(2)}

Name

League of Women Voters of Nebraska

Office Phone

(402) 475-1411

Office Address (Street, Box, or Route)

4600 Valley Road, Suite 306

Official to Whom Lobbyist is Accountable

City

Lincoln

State

Zip

68510

Nature of Business {49-1480(3)}

Voter Education & Advocacy

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)} Voting rights, redistricting, government, natural resources, social policy, & education

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

Names and addresses of principal's officers:

Linda Duckworth & Dianne Bystrom - Co-presidents, League of Women Voters of Nebraska

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.

Moulton, MaryLee

Lobbyist Name

Dec 31, 2019

Date