FORM
A-R
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Dec 20, 2023

(This report is required to be filed on or before December 31 of each calendar year.)
49-1480.01(3)

Amended Registration
Lobbyist Registration Fee:
{49-1480.01}

(If you are a salaried employee of your principal, you are a compensated lobbyist.)
(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)}

54906 N. 180th Ave. 

same 

Fullerton 

NE 

68638 

same 

NE 

same 

(308) 550-0614 

(308) 536-2082 

annette.dubas@nabho.org 

PRINCIPAL {49-1480(2)}

(308) 550-0614, Ext. 3085500614 

P.O. Box 36 

NABHO President 

Fullerton 

NE 

68638 

HEALTH 

AMOUNTS GIVEN
1,000.00  Per Month  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Behavioral Health and Substance Use  
Description of industry, trade, profession, or interests and groups represented by the principal:
 
Names and addresses of principal's officers:

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:

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

Annette Dubas

Lobbyist Name

Dec 20, 2023

Date