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Federal Use Only: Authorized for Local Reproduction Standard Form LLL (Rev. 7-97) INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disciosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a materiai change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreementto make payment to any lobbying entity for infiuencing or attempting to infiuence an officer or employeeof any agency, a Member of Congress. an officer or employeeof Congress, or an employeeof a Memberof Congress In connection with a coveredFederal action. Use the SF-LLLA ContinuationSheet for additional information if the space on the form is inadequate. Complete ali items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is andlor has been secured to Infiuence the outcome of a covered Federai action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported, enterthe year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federalaction. 4. Enter the full name, address, city, State and zip code of the reporting entity. Inciude Congressional District. ~ known. Check the appropriateclassification of the reporting entity that designates if it is, or expects to be. a prime or subaward recipient. Identify the tier of the subawardee.e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name. address, city. State and zip code of the prime Federalrecipient. Inciude Congressional District, if known. 6. Enter the name of the Federai agency making the award or ioan commitment. Include at least one organizationallevel below agency name, if known. For exampie, Department of Transportation, United States Coast Guard. Enter the Federai program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 7. B. Enter the most appropriate Federal identifying number available for the Federai action identified in item 1 (e.g., Request for Proposal (RFP) number; Inv.ation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposai controi number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federai agency, enler the Federal amount of the awardlloancommitmenl for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the iobbying entity engaged by the reporting entity identified in item 4 to infiuence the covered Federal action. b) Enter the full names of the individuai(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonabiyexpectedto be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that appiy. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriatebox(es). Check all boxes that apply. If paymentis made through an in-kind contribution, specify the nature and value of the in- kind payment. 13. Check the appropriate bðx(es). Check all boxes that apply. If other, specify nature. 14. Provide a specific and detaileddescrlption of the services that the lobbyist has performed. or will be expectedto perform, and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federai officials. Identify the Federal official(s) oremployee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacted. 15. Check whether or not a SF-LLLA Continuation Sheet(s) is attached. 16. The certifying officiai shall sign and date the form, print his/her name, titie, and teiephone number. 11