|
EXHIBIT H
<br />Page 1 of 3
<br />
<br /> Exhibit H
<br />6744 Federal ReRister Volume 55, No. 381 Monday~ February 26, 19901 Rules and Regulations
<br />
<br />Instructions for Completion of SF-LLL Disclosure of Lobbying Activities
<br />
<br />This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at
<br />the initiation or receipt of a covered Federal action, or a matedal change to a previous filing, pursuant to title 31
<br />U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying
<br />entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an
<br />officer or employee of Congress. or an employee of a Member of Congress in connection with a covered Federal
<br />action, Use the SF-LLL-A Continuation sheet for additional information if the space on the form is inadequate.
<br />Complete all items that apply for beth the initial filing and material change report. Refer to the implementing guidance
<br />published by the Office of Management and Budget for additional information.
<br />
<br />1. Identify the type of covered Federal action for which lobbying is and has been secured to influence the outcome of
<br />a covered action.
<br />2. Identify the status of the covered Federal action.
<br />3. Identify the appropriate classification of this report. If this is a follow up report caused by a matedal change to the
<br />information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last
<br />previously submitted report by this reporting entity for this covered Federal action.
<br />4. Enter the full name, address, city, state and zip code of the reporting entity. Include congressional district, if known.
<br />Check the appropriate classification of the reporting entity that designates if it is, or expects to be a prime or
<br />subeward recipient.
<br />Identify the tier of the subawardee, e. g. the first subawardee of the prime is the 1st tier. Subawards include but ara
<br />not limited to subcontracts, subgrants and contract awards under grants.
<br />5. If the organization filing the report, in item 4 checks "Subawardee", then enter the furl name, address, city, state,
<br />and zip code of the pdme Federal recipient. Include congressional district, if known.
<br />fi. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational
<br />level below agency name, if known. For example, Department of Transportation, United States Coast Guard.
<br />7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full
<br />Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan
<br />commitments.
<br />8. Enter the most appmpdata Federal identifying number available for the Federal action identified in item 1 (e. g.
<br />Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number the contract, grant.
<br />or loan award number; the application proposal control number assigned by the Federal agency), Include prefixes,
<br />e.g., "RFP-DE-90-09."
<br />9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the
<br />Federal amount of the award/loan commitment for the pdmary entity identified in item 4 or 5.
<br />10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity
<br />identified in item 4 to influence the covered Federal action.
<br /> (b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a).
<br />Enter Last Name, First Name, and Middle Initial (MI).
<br />11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the
<br />lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all
<br />boxes that apply. If this is a material change report enter he cumulative amount of payment made or planned to be
<br />made.
<br />12. Check the appropriate box(es). Check all bexes that apply. If payment is made through an in-kind contribution,
<br />specify the nature and value of the in-kind payment.
<br />13. Check the appropriate bex(es). Check all boxes that apply. If other, specify nature.
<br />14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to
<br />perform, and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in
<br />actual contact with Federal officials. Identify the Federal official(s) or employee(s) contacted and the officer(s),
<br />employee(s), or Member(s) of Congress that were contacted.
<br />15. Check whether or not a SF-LLL-A Continuation Sheet(s) is attached.
<br />16. The certifying official shal~ sign and date the form, print his/her name, title, and telephone number.
<br />
<br />Public reporting burden for this collection of information is estimated to average 30 minutes per response, including
<br />time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
<br />completing and reviewing the collection of information. Send comments regarding the burden estimate or any other
<br />aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management
<br />and Budget. Paperwork Reduction Project (0348-0046) Washington D. C., 20503.
<br />
<br />
<br />
|