Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Oct 24, 2023

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

Atkins, Michaela

Office Address (Street, Box, or Route)

6001 Dodge St. CEC 117A

Permanent Residence (Street, Box, or Route)

6014 N 35th St.

City

Omaha

State

Zip

68182

City

Omaha

State

Zip

68111

Office Phone

(712) 310-7307

Home Phone

(402) 800-6654

Email Address

michaela@elevateomaha.org

PRINCIPAL {49-1480(2)}

Name

Elevate Omaha Inc.

Office Phone

(712) 310-7307

Office Address (Street, Box, or Route)

6001 Dodge St. CEC 117A

Official to Whom Lobbyist is Accountable

Nicole Clark

City

Omaha

State

Zip

68182

Nature of Business {49-1480(3)}

Nonprofit Youth Services

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Issues impacting young people

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

Names and addresses of principal's officers:

Malena Rosseau & Madisen Reed
6001 Dodge St. CEC 117A Omaha, NE, 68182

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.

Michaela Atkins

Lobbyist Name

Oct 24, 2023

Date