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INMUCUoNg C(A COMPt3 ON OF SF411-, tASCLOSURt Of COMKVlNG ACTIY(Tfi;S
<br />TWA ditctoture form ttutl ht campteted �ry ttte rcpat(fot endty, QM etltcf tAAW i:t -at pdwt Fedetsl redptent, at the
<br />1a(400n of tect(pt of i <,(W ed rtderil Rdtan, of A mAWA d,intt to i pt•a,taut ftEl t& ptesnaant to title 31 IIS.0
<br />tecdoo 1151. The two$ of a form It retiu(&d for eacft pt�yment of .pre to "144 paymtut to any tabtrytnd entity for
<br />krtiuendrrt ar aitcmpttr+� to tnduenr�a aW t of etrtr 10Vt4 of tei0q, a Membtt at Can"tt, an atttcer ar
<br />trte" of Condrett, at an tntployte of a Mem6tt 6f C arett in cann�ttton with a coveted Federal action. Utt the
<br />SF-itL-A Cantinuat3on Sheet (at ad ittonM tototmitton If the tptce an the form It Intdeetuate. Carnptetc All itcmt Ittst
<br />apply (or160th the initiaf Moo Ind material d,tn ftpott. omtctet to tke fmplo06t* tufdtnce pub(lihed by1he (Mot at _
<br />tnastmtnt and tiud�cl far addttiortrl fnlarmt�a an,
<br />1. WM(ty the type of covered Fedora "on for %Wd-i fobbytnt &dMty k snd/ot htt been tecur -to Wtvt nce the
<br />outcome of a covered Federal action.
<br />Z. lderttify (tit tttws of tilt covtrtd Federal tct(an.
<br />]. tdtntity the appraptitte dsts(tictt(urti of thlt apart, if this tt a fatto"s rcpod eaused fey a material chinggc to the
<br />wormatfoa prtvlautiy the year And c(utrter in wild, the ch"t occurred. Enter the ditt of the lart
<br />PvWOus(y tubmltted rtport fry ttdt Apart(nt ertttty 6 r 041 covered Ftdcral action.
<br />4. Enloe the fur( name, addrett, City, etstt and Zip code bf the Impod, !M(ty. Include Congretttona) ottttict, It
<br />known. Check the a Ate dattt(icatlan of the tepotti" 4tntlty that deilt"t" 1f ft It, of expectt to be.'* prime
<br />or tubaward ec�dp1enntnt(fy tt�e tier of tt6 eubtwardct, t4 the fiat tubswardce of the prime it the III tilt.
<br />SU6twatdt tntfude but are rtot ttm(tcd to tn,beontrictt, tntbattMt artd c444tact awatdt undo poott. .
<br />5, tf 16 atgan(uttan 6409 the pott M ftetn 4 thtr-6 "Subtnvtedee : then entet the tuft name, address, city, ttatt tnd
<br />xip tode of the prim,- fr�cederal redpleM, Include Qmjtettlonel dtttdct # known.
<br />i. 640 the name of the Wttal aft ma the award or ban camtn(trnent. Itrtfude at itju ane araaait:tianal
<br />levtf + ad if rn4'+ If knoyM FW eXatstpl4 dcpartv"nt of'iwOpodst(on, United Statet-Caast Cursed.
<br />7. Entet the Fcdetd. or "me 41ctctip(tan far the coveted Federal td(" ((tern -1). If kn�. enter the (A.
<br />Gtato� e( Federal ba tttc Ats(tt nett {Ckpil} Itutttbtr (at V mtt, eoaperitfve itteemeuts, lotnt. and toan
<br />Comm;twtntt. -
<br />fi. Eater the AIM( appt.6Mt k kdtW IdeABfyiq tt"bo avtl(tbte for 4w 4dettt! action m4mo red 1" Item t (a6„
<br />Iter;ttttt fat tw"ai (RM estartixe' • �tatl for fttd Orat numbetf -fit ateg owKement ttwnbt . the- convict,
<br />grat4, or taatt award tKkAtt; the a pp"tanlptapGQ mos<htrl'aumher *fruited by the Federal sgto j. (odude
<br />ptelitc % e.t,, " RtP-)f:-44441 "
<br />4. For I< cavettd Fe& M adlaa where thete Im beets to award or.lot" co�finent by the Fedora) a�tency, enter ttta
<br />f= itiA amount of the tiw*aoan bxi%"4 � for tftt prime entity 1deM(fted in Rem 4 at s
<br />t0. (A)Wt t (tit full name, iddrettt. dly, ante ittd tin ,-ode of the k&Wt% tktt q ttttgaged by the "patting entity
<br />(dentlt(ed In item 4 to (ttfMueace (64 tw&4M Federal fetid". 1
<br />(6)bntet the fuU clam"of the lndhrtduaf{E) (retlott+nM* feMces, and tncludt $A tddeen U'dWercnt #weft 10 (t).
<br />61.tt 4 rtt Name, Pint fl*ne, end MtdAt tf al (Mt).
<br />Al. EtAtt the amount of cWT"tao(m paid at reaianab4y tt rec4ed to Ise paidby the repad(at entity (item 4) to the
<br />lowtj ta0ty (item ta). Indicate wftedw the t1sr, lent hat been made teduil) or v&I (it made {planned). Check
<br />all lwicts tfttt appllr. if titi� H t ntattttaf ,-llama ttprstb tMer the ctunufith* &WKMf of payment made ar planned
<br />to bt: msdt,
<br />13- Check the appprroptlate fsou(ta). the& all lraxr
<br />et that . If piyrnent 6 tntftta a& ugh sin tin-Und contribution,
<br />ttedfy the nature ford vtiut of the to -kind p"tnt,
<br />13. t tecMc the tpptoplute box{r►ty. Chtdc Al hoxti thtt apply. If other, specify trrturf<.
<br />14. Pvc Malt t tptd(ic" detailed detestpNutt of till! 1erAcet that the lob"tt h#i Wormed, at %01 be expe<tied to
<br />perform, and the dAWO a( thy st-Mc-4 ttoJvtd.
<br />ConInclude allp" pasNary And related is Aty, not Putt time jpPtnt in
<br />actO4 contact Wth ftdetai oWt1t. tdtnt(fy f tdtral otftctttttf or ttrttayee{s)
<br />picontacted at the aHfctttt),
<br />bgre41 tht4 wet!
<br />tmploytt(ti, or Mem&tr(t) f cottttcted.
<br />t5. Check whethet of not 4 St4A-i-A Crsnt (Wid" Stt,-et(tl ft hitched.
<br />Ib. The ftsiiWt oMda 461010 tM date t(A f print tM et Mme, l(t1r3, tact Icitphattc tttttrt6Fcr<
<br />f't,W- "tf 6tt bucdcn tar M ea(ttcdon of fKttbnnw m k-WWAitd to Mate i4 tttlnti Ft pet ttspo k, k+cludj tame t., rcvirYi�R
<br />tnrtr+scrlortt, tt+rclrtr.t 4-o"rA data wince,-, teti*A'i laid tiu"lai4,t drte dart ntedcd.-W co"Ve" 6M rtv4Kir4 t#.t cottttttor 04.
<br />k,t«.r,, t3otk lard ca<nmt„ti tt{ "'i 4*0 trur� *+fungi* 6r edrrr "poet of "cottecte<M 64 Marton, 6c10L t04 t "tWom
<br />40, lcduck4 d t+ <4 4.,t O+K4 hA Manr,rttnenl tnd iAti, t"tw*A Rtciuctiatt f T� to3:# vAt). Wrxhkrteoa O.C. lasoS.
<br />A`PrAct "r, ET 1 1t7 EXHIBIT C
<br />PAGE TWO OF `fltRJ--E PAGES
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