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 initiation or receipt of a covered Federal <br /> action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreementto make <br /> paymentto any lobbying entity for influendng or attempting to influence an officer or empbyeeof any agency, a Member of Congress, an officer or employeeof <br /> Congress, or an employeeof a'Memberof Congress in connection with a covered Federal action. Use the SF-LLLA Continuation Sheet for additional information ff <br /> the space on the form is inadequate. Complete ail items that apply for both the initial filing and material change report. Refer to the implementing guidance <br /> published by the Office of Management and 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 outcome of a covered Federal action. <br /> 2. Identify the status of the covered Federal action. <br /> _ 3. Identify the appropriatedassification of this report. If this is a foliowup report caused by a material change to the information previously reported, enter <br /> the year and quarter in which the change occurred. Enter the date of the last previousysubmitted report by this reporting entity for this covered Federal <br /> action. <br /> 4. Enter the full name, address, dty, State and zip code of the reporting entity. Indude Congressional District, if known. Check the appropriatedassification <br /> of the reporting entitythat designates if it is, or expects to be, a prime or subaward redpient. identify the tier of the subawardee, e.g., the first subawardee <br /> of the prime is the 1st tier. Subawards indude 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, dty, State and zip code of the prime Federal . <br /> redpient. indude Congressional District, 'rf known. <br /> 6.. Enter the name of the Federal agency making the award or loan commitment. indude at least one organizationallevel below agency name, ff known. For <br /> 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 knovm, enter the full Catalog of Federal Domestic Assistance <br /> ' (CFDA) number for grants, cooperative agreements, loans, and loan commitments. <br /> 8. Enter the most appropriate Federal identifying number availablefor the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number, <br /> ! Invitation for Bid (IFB) number, grant announcement number; the contract, grant, or loan award number, the application/proposalccntrol number <br /> assigned by the Federal agency). Include prefixes, e.g., "R-FP-DE=90=001:'-~-^~~-------~~ - <br /> i 9. For a covered Federal action where there has been an award or loan commitment by the-Federal agency, enter the Pectoral amount of the award/loan <br /> commitment for the prime entity identified in item 4 or 5. <br /> 10. (e) Enter-the-full-name, addrosa, oity,:State and zip code of the loht~ying r3ntlty engaged by the reporting entity identified in item 4 to influence the covered <br /> -Federal action-- _ <br /> ~ (b) .Enter the full names of the individual(s). performing services, and indude full address ff different from 10 (a). Enter East Name, First Name, and <br /> Middle Initial (MI). _ _ ~ _ <br /> <br /> i <br /> 1 L_Enter-the amountof compensationpaid or reasonablyexpectedto be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether <br /> _ _ _ _ . ~ „ _ _ _ _ _ . - - 1f ~ihis-is a materialxhan e c rt; enter--the-cumulative <br /> -tt~e-f~IR'''®nt_has_been made-(actu3l~?r ~iiLbe~_tnade_(A1~DrtQd). Check <br /> atl boxes"that°apply_ 9 - ~ - F.- <br /> amount of payment made or planned to be made. <br /> 12. Check the appropriatebox(es). Check all boxes that apply. If paymentis made through an in-kind contribution, spedty the nature and value of the in-kind ^ <br /> payment. <br /> 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. <br /> 14. Provide a specific and detaileddescription of the services that the lobbyist has performed, or will be expected to perform, and the date(s) of any services <br /> rendered. Indude ail preparatory and related activity, not just time spent in actual contact with Federal offidals. Identify the Federal offidal(s) or { <br /> employee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacted. i <br /> 15. Check whether or not a SF-LLLA Continuation Sheet(s) is attached. <br /> 16. The certifying offidal shall sign and date the form, print his/her name, title, acid telephone number. <br /> According to tha Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless ff displays a valid OMB Control <br /> Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is <br /> estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the da <br /> needed, and completing and reviewing the collodion of information. Send comments regarding the burden estimate or any other aspect of this collection of <br /> information, including suggestions for redudng this burden, to the Office of Managementand Budget, Paperwork Reduction Project (0348-0046). Washipgton, j <br /> DC 20503. <br /> t <br /> , <br /> ~ <br /> <br />