Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 26, 2023

(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

Catalyst Public Affairs

Office Address (Street, Box, or Route)

301 South 13th Street, Suite 402

Permanent Residence (Street, Box, or Route)

City

Lincoln

State

Zip

68508

City

State

Zip

Office Phone

(402) 261-5293

Home Phone

Email Address

tgay@catalystnebraska.com

PRINCIPAL {49-1480(2)}

Name

Nebraska Health Information Initiative, Inc.

Office Phone

(402) 506-9900

Office Address (Street, Box, or Route)

PO Box 27842

Official to Whom Lobbyist is Accountable

Dr. Jaime Bland

City

Omaha

State

Zip

68127

Nature of Business {49-1480(3)}

Health Information Exchange

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
6,000.00 Per Month

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Information Exchange

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

Names and addresses of principal's officers:

Dr. Jaime Bland, PO Box 27842 Omaha NE 68127

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.

Catalyst Public Affairs, Inc.

Lobbyist Name

Dec 26, 2023

Date