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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.
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