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. DL~.LOSURE OF LOBBYING ACTIVITIt.,' Approved by ones <br /> Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 o34s-ooas <br /> See reverse for ublic burden disclosure. <br /> 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: <br /> <br /> ' a a. contract ~a. bid/offer/application ~ a. initial filing , <br /> b. grant b. initial award b. material change <br /> c. cooperative agreement c. post-award For Material Change Only: <br /> d. loan year quarter <br /> e. loan guarantee date of last report <br /> f. loan insurance <br /> 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name <br /> Q Prime ?Subawardee and Address of Prime: <br /> Tier if known <br /> Twht;~ l~JotcS p~~#'m~.~ <br /> 1;5~ ~>~rl <br /> ~ ~ '~17f Fourth <br /> Con esstonal District, ifkriowrt: Con ressional District, ffknown: <br /> 6. federal Department/Agency: 7. Federal Program Name/Description: <br /> ~t,t.C'~~ o ~ I''I rx~ ~ ~ m <br /> CFDA Number, if~pplieable: <br /> 8. Federal Action Number, ifknown: 9. Award Amount, if known: <br /> f~ssySf~r.2, I~ fet~„~.Gc„-f' l7t-~~9-D3 ~1~DL~ $ <br /> 10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (irrcft.rd~ng.addiess:f <br /> (if~a~~?du~l, last narr?i;; fast Hattie, Mi): different frDm':No 1Oa) <br /> Sm~`'1'~-- Dc~',5~~ ~ ~n~~e~S (last name frrstnarrie;Ml): " <br /> 1 aoa Cr~n~lt~=f'iG+N't" l~v~f lU"v Tim Smith, Kirk Bailey, Tom Dawson, and Greg Andrews <br /> 11. Information requested through this form is authorized by title 31 U.S.C. section ~ <br /> 1352. This disaosure of lobbying aictivNes is a material representation of tea Signature: <br /> upon which reriance was placed by the tier above when this transaction was made <br /> or entered into. This disdosura is required pursuant to 31 U.S.C. 1352 This Print Name: Dennis M. Taylor <br /> information will be reported to the Congress semiannually and will be available for Cl Maria er <br /> public inspection. My person who fails to file the required disdosure shall be Title: Ty g <br /> subject to a evil penalty of not less that 510,000 and not more than 5100,000 for / d~ <br /> eaa, such failure. Telephone No.: (541) 682-5336 Date: ` <br /> r„ p <br /> g Authorized for Local Re roduction <br /> Federal Use, ,nt h' <br /> ~ ~ ~ ~ ' ' _ Standard Form LLL (Rev. 7-97) <br /> <br />