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CIO
<br /> INSTRUCTIONS FOR COMPLETION OF SF -LLL, DISCLOSURE OF LOBBYING ACTIVITIES
<br /> This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the •
<br /> initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section
<br /> 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing
<br /> or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress,
<br /> or an employee of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both
<br /> the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and
<br /> Budget for additional information.
<br /> 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the
<br /> outcome of a covered Federal action.
<br /> 2. Identify the status of the covered Federal action.
<br /> 3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the
<br /> information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last
<br /> previously submitted report by this reporting entity for this covered Federal action.
<br /> 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if
<br /> known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or
<br /> subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier.
<br /> Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
<br /> 5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and
<br /> zip code of the prime Federal recipient. Include Congressional District, if known.
<br /> 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level
<br /> below agency name, if known. For example, Department of Transportation, United States Coast Guard.
<br /> 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full
<br /> Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan
<br /> commitments.
<br /> 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g.,
<br /> Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract,
<br /> grant, or loan award number; the application/proposal control number assigned by the Federal agency). Included
<br /> prefixes, e.g., "RFP- DE -90- 001."
<br /> 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the
<br /> Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.
<br /> 10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act
<br /> of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action.
<br /> (b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a).
<br /> Enter Last Name, First Name, and Middle Initial (MI).
<br /> 11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
<br /> According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays
<br /> a valid OMB control Number. The valid OMB control number for this information collection is OMB No. 0348 -0046. Public reporting
<br /> burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions,
<br /> searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
<br /> Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this
<br /> burden, to the Office of Management and Budget, Paperwork Reduction Project (0348 - 0046), Washington, DC 20503
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