Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 13, 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

Lee-Chambers, Gayla

Office Address (Street, Box, or Route)

4401 north 21 Street

Permanent Residence (Street, Box, or Route)

5421 South 33 street

City

omaha

State

Zip

68110

City

omaha

State

Zip

68107

Office Phone

(402) 451-5549

Home Phone

Email Address

corporateoffices4401@gmail.com

PRINCIPAL {49-1480(2)}

Name

Saratoga History - Arts- Humanities Multicultural Center

Office Phone

(402) 451-5549

Office Address (Street, Box, or Route)

p.o. box 19235

Official to Whom Lobbyist is Accountable

City

omaha

State

Zip

68119

Nature of Business {49-1480(3)}

multicultural center

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)} help with fundraiser for economic development

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

Names and addresses of principal's officers:

gayla lee-chambers p.o. box 19235 Omaha, ne 68119

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)}

gayla lee-chambers 4401 north 21 street Omaha, Ne 68110

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

gayla lee-chambers

Lobbyist Name

Dec 13, 2023

Date