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EXHIBIT 1 <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />Complete this form to disolose lobbying activities pursuant to 31 U.S.C. 1352 <br />(See reverse for public burden disclosure) <br />of Federal Action <br />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: 6. If Reporting Entity in No, 4 Is a Subawardee, <br />Prime Subawardee Enter Name and Address of Prime: <br />Tier , /f known: <br />Congressional District, f known: -- Congressional District, !f known: _ <br />6, Federal Department/Agency: 7. Federal Program Name/Description: <br />CFDA Number lfa !/cable; <br />8, Federal Action Number, if known: 9. Award Amount, if known: <br />10,a. Name and Address of Lobbying Entity b. Individual Performing Services (include address <br />(if individual, last name, first name, Ml): if different from No. 10a.) <br />last name, firsfi name, MI): <br />_ (attach Continuation Sheet (s) Sl;-I Sr -A, if neceasary) _ <br />11. Amount of Payment (check all that apply): 13. Type of Payment (check all that apply):"°°.. <br />Actual -planned T--stainer <br />12, Form of Payment (check all that apply): b. one-time fee <br />a. cash c. commission <br />b. in -kind; specify: nature d. contingent fee <br />value a, deferred <br />- - f. other; specify, <br />14, Brief Description of Services Performed orto be Performed and date(s) of Service, including <br />officer(s), employee(s) or Members) contacted, for Payment Indicated on Item 11: <br />Continuatlon Sheet <br />Yes No <br />16, Information requested through this form Is authorized by <br />Title 31 U.S.C. Section 1352. This disclosure of <br />Signature; <br />lobbying activities is a material representation of fact <br />upon which reliance was placed by the tier above when <br />Print Name: <br />this transaction was made or entered into. Thia dis- <br />closure Is required pursuant to 31 U.S.C. 1352. This <br />Title: <br />information will be reported to the Congress aeml- <br />annually and will be available for public inspection. Any <br />person who fails to file the required disclosure shall be <br />Telephone No.; Date: <br />subject to a oMl penalty of not less than $10,000 and <br />not more than $100,000 for each such failure, <br />Federal Use only: <br />INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES <br />Authorized for Local Reproduction <br />Standard form - LLL-A (Rev. 7-97) <br />