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Exhibit 4 <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />Complete this form to disclose activities pursuant to 31 U.S.C 1352 <br />1.Type of Federal Actions: <br />a. contract <br />b. grant <br />c.cooperative agreement <br />d. loan <br />e.loan guarantee <br />f.loan insurance <br />2.Status of Federal Actions: <br />a. bid/offer/application <br />b.initial award <br />c.post-award <br />3.Report Type: <br />a.initial filing <br />b.material change <br />For material change only: <br />Year: Quarter: <br />Date of last report: <br />4.Name and Address of Reporting Entity <br />Prime Subawardee <br />Tier if known <br />Congressional District, if known: <br />5.If Reporting Entity in No. 4 is a Subawardee: <br />Enter Name and Address of Prime: <br />Congressional District, if known: <br />6.Federal Department / Agency:7.Federal Program Name/Description <br />8.Federal Action Number, if known:9.Award Amount, if known: <br />$ <br />10a. Name and Address of Lobbying Entity <br />(if individual, last name, first name, MI): <br />(attach Continuation Sheets SF-LLL-A, if necessary) <br />10b. Individual Performing Services <br />(including address if different from No. 10a) <br />(last name, first name, MI): <br />11.Amount of Payment (check all that apply): <br />$ Actual <br />Planned <br />13.Type of Payment (check all that apply) <br />a. retainer <br />b. one-time free <br />c. commission <br />d.contingent fee <br />e. deferred <br />f.other specify: <br />12.Form of Payment (check all that apply): <br />a.cash <br />b.in-kind: specify: <br />nature: <br />value: <br />14.Enter Description of Services performed or to be Performed and date(s) of Service, including officer(s), employee(s), or Member(s) <br />contacted, for Payment indicated on item 11: <br />15.Continuation sheet(s) SF-LLL-A attached: Yes No <br />16.Information requested through this form authorized by Title <br />31 U.S.C. Section 1352. This disclosure of lobbying activities is a <br />material representation of fact upon which reliance was placed by the <br />tier above when this transaction was made or entered into. This <br />disclosure is required pursuant to 31 U.S.C. 1352. This information <br />will be reported to the Congress semiannually and will be available for <br />public inspection. An person who fails to file the required disclosure <br />shall be subject to a civil penalty of not less than $10,000 and not <br />more than $100,000 for each such failure. <br />Signature: <br />Print Name: <br />Title: <br />Telephone No: <br />Date: <br />EXHIBIT 1