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<br />INSTRUCTIONS FOR COMPLETION OF SF.LLL. DISCLOSURE OF LOBBYING ACTIVITIES
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<br />This disclosure form shall be completed by the reporting entity I whether subawardeeor prime Federat recipient, at the initialion or receipt of a covered Federal
<br />action, or a material change to a previous filing, pursuant to tiUe 31 U.S.C. section 1352. The filing of a fonn is required for each payment or agreementto make
<br />paymentto any lobbying entity for influencing or attempting to i"nuance an offICer or employeeof any agency, a Member of Congress, an officer or employee of
<br />Congress, or an employeeof a Memberof Congress in connectionwilh a covered Federal action. Use the SF.lLLA Continuation Sheet for addilional information if
<br />the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance
<br />published by the Office of Management and Budget for additional Information.
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<br />1. Identify the type of covered Federal action for which lobbying acllvity is and/or has been secured to Influence the outcome of a covered Federal action.
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<br />2. Identify the status of the covered Federal action.
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<br />3. Identify the appropriateclassiflC8tion of this report. If this is a followup report caused by a material change to the information previously reported, enter
<br />the year and quarterin which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal
<br />action.
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<br />4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District. if known. Check the appropriateclassification
<br />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
<br />of the prime is the 1st tier. Subawards include bulare not limited to subcontracts, subgrants and contract awards under grants.
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<br />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 Federal
<br />recipient. Include Congressional District, if known.
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<br />6. Enterthe name of the Federal agency making the award or loan commitment. Include at least one organizationallevel below agency name, If known. For
<br />example, Department of Transportat10n, United States Coast Guard.
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<br />7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance
<br />(CFDA) number for grants, cooperative agreements, loans. and loan commitments.
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<br />8. Enter the most appropriate Federal identifying number availablefor the Federal action Identified In Kern 1 (e.g., Request for Proposal (RFP) number:
<br />Invitation for Bid (IFB) number. grant announcement number; the contract, grant, or loan award number. the application/proposal control number
<br />assigned by the Federal agency). Include prelixes, e.g., "RFP.DE-eO-o01."
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<br />9. For a covered Federal action where there has been an award or 50an commitment by the Federal agency, enter the Federal amount of the awardlloan
<br />commitment for the prime entity identified in item 4 or 5.
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<br />10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to Influence the covered
<br />Federal action.
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<br />(b) Enter the full names of the individual(s) performing services, and Include full address If different from 10 (a). Enter Last Name, First Name, and
<br />Middle Initial (Mil.
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<br />11. Enter the amount of compensation paid or reasonablyexpectedto be paid by the reportlngentlty(ltem 4) to the lobbying entity (Item 10). Indicate whether
<br />the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this Is a material change report, enter the cumulative
<br />amount of payment made or planned 10 be made.
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<br />12. Check the appropriatebox(es). Check all boxes that apply. If paymentls made through an In-kild contribution. specify the nature and value of the in-klnd
<br />payment.
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<br />13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.
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<br />14. Provide a specific and detailed description of the services that the lobbylslhas performed, or will be expected to perform, and the dale(s) of any services
<br />rendered. Include aU preparatory and related activity, not Just time spent In actual contact with Federal officials. Identify the Federal offlcial(s) or
<br />employee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacled.
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<br />15. Check whether or not a SF-LLLA Continuation Sheet(s) Is attached.
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<br />16. The certifying official shall sign and date the form, print hlslher name, title, and telephone number.
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<br />According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of Information unless It displays a valk:l OMS Control
<br />Number. The valid OMB control number for this Information collection is OMS No. 0348-0046. Public reporting burden for this collection of Information is
<br />estimated to average 30 minutes per response, including time for reviewing Instructions, searching existing data sources, gathering and maintaining the data
<br />needed, and completing and reviewing the coUectlon of information. Send comments regarding the burden estimate or any other aspect of this collection of
<br />infonnation, Including suggestions for reducing this burden, to the OffIce of Managementand Budget, Paperwork Reduction Project (0348...Q046), Washington,
<br />DC 20503.
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