CAREER BEGINNINGS OF O.C. 1 - Laserfiche WebLink

Home Browse Search

DISCLOSURE OF LOBBYING ACTIVITIES Approved byoMa Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 o3as-ooas (See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Aetion: 3. Report Type: a. contract ~a. bidloffer/application ~ a. initial filing b. grant b. initial award b. material change c. cooperative agreement c. post-award For Material Change Only: d. loan year quarter-- e. loan guarantee date of last report f, loan insurance 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name ^ prime ^ sabawardea and Address of Prime: Tier____, ifknown: Con ressional District, ifknown: Con ressional District, ifknown: 6. Federal Department/Agency: 7. Federel Program Name/Description: CFDA Number, ifapplica6le: ___, 8. Federal Action Number, ifknown: 9. Award Amount, ifknown: 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual, last name, first name, MI): di8erent from No. 10a) (Iastname, first name, MI): attach Conttnuation Shee ts SF-LLL4, ilnecessa 11. Amount of Payment (check all that apply): 13. Type of Payment (check all that apply): _ ^ actual ^ planned ^ a. retainer ^ b. one-time tee 12. Form of Payment (check all that appy): ^ e. eommission ^ a. sash ^ d. contingent fee ^ b. in•kind; specify: nature _ ^ e. defartad V81Ue ^ f. other, specify: 14. Brief Description of Services Pertormed or to be Pertormed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacted, for Payment Indicated in Item 11: attach Contlnuatton Sheet(s) SF-LLLA, 7neces ) 15. Continuation Sheets SF-LLLA attached: ^ v., No 15 Mlo,metlon rpusetstl Mmuen Mk lortn b suMO,ixatl M tlua 3t U.S.C. asctlon 1352 7Ma 7hdnure W IoEb/0q adMWS b a maMrlal raprsemletion of hd Si nature: g upon wMch rdMCewu plaead by Ms rw aEwa vMan Mb lnnaaWm was matla ar enEe,atl IMO TNa dbdorwa b ,agd,atl punuanl b 31 UBC 134 Thk print Name . . . Mbrmatlm wa W repMMb Ma ConVaaa asmNnm,ap antl wa M an3ada far Pubin Inapao0m. My parson wlu feM b ee ea raquM dWOSUrv aM0 a Title: au0lad b • dull penely of nd baa Mat 510.000 antl not mas Man N WAae fw ••~~f•~• Telephone No.: Date: Federal t~BeOfrly: Authorized for Local Reproduction Standard Form LLL (Rev. 7-97)