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DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB <br />Complete this-form to disclose lobbying activities pursuant to 31 U.S.C. 1352 ;_149I-0046 <br />{See reverse for public burden disclosu -e.} ' <br />1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: <br />a. contract ~a. bid/offer/application ❑ a. initial filing <br />b. grant b. initial award b. material ch ge <br />c. cooperative agreement c- post-award For Material Change Only: <br />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 (p. 4 is a Subawardee, Enter Name <br />❑ Prime ❑ Subawardee and Address of Prim <br />Tier if known: <br />A P <br />Congressional District, if known: 4c Congressional District, if known: <br />6. Federal Department/Agency: 7. Federal Program Name/Description: <br />CFDA Number, if applicable: <br />8. Federal Action Number, if known: 9. Award Amount, if known: <br />10. a. Name and Address of LobbyingAegistrant b. Individuals Performing Services (inc.cldding address if <br />(if individual, last name, first name, Ml): different from No. 10a) <br />{ (last name, first name, Ml): <br />~F. <br />~P <br />Fir <br />a' <br />Information requested thnwg 4I s form is authorized by title 31 U.S.C. section <br />11.1352. This disclosure of 112-tying activities is a material representation of fad Slgrlature: <br />upon which reliance was~pfaced by the tier above when this transaction was made Print Name: MICHAEL-C. W I L°D I S H <br />or entered into. Thl.isclosure is required pursuant to 31 U.S.C. 1352. This <br />Information will be,available for public inspection. Any person who falls to Cite the <br />required drsclosrue' shall be subject to a civil penally of not less than $10,000 and Title: VICE P RE S I D E N T <br />not more than <br />,,/$400,000 for each such failure. ' <br />Telephone No.: 541-485-1700 Date: <br />Authod zed for Local Reproduction <br /> <br />De=:::~a,_:•_-~r:~::~~m.~:-:::-:.~~~ ,,,w:~..,,,-;;-:~~~,~,=:.: . Standard Form LLL (Rev.7 971 <br />