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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 Federal recipient, at the inillation or receipt of a covered Federal
<br />action, or a material change to a previous filing, pursuant to fiUe 31 U.S.C. section 1352. The filing of a form Is required for each payment or agreement to make
<br />payment to any lobbying entity for influencing or attempting to Influence an officer Of employee of any agency, a Member of Congress. an offICer or employeeof
<br />Congress, or an employeeof a Memberof Congress in connection with a covered Federal action. Use the SF-LLLA Continuation Sheet for additional Information if
<br />the space on the fonn 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 lobby]ng activity is andlor has been secured to innuance the outcome of a covered Federal aclion.
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<br />2. Identify the status of the covered Federal actIon.
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<br />3. Identify the appropriate classification of this report. If this Is a followup report caused by a material change to the information previously reported. enter
<br />the year and quarter In which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal
<br />aclion.
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<br />4. Enter the full name, address, city, Slate 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, 8 prime or subaward reclpienl Identify the Uer of the subawardee, e.g., the first subawardee
<br />of the prime Is the 1 st tIer. Subawards Include but are 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, Slale and zip code of the prime Federal
<br />recipient. Include Congressional District, if known.
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<br />6. Enter the name of the Federal agency making the award or loan commilment.lnclude at least one organlzaUonallevel below agency name,]f known. For
<br />example, Department of Transportation. 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 />6. Enter the most appropriate Federal identIfying number availablefor the Federal action identified In item 1 (e.g., Request for Proposal (RFP) number;
<br />Invitation for Bid (IFB) number. grant ennouncement number; the contract, grant, or loan award number; the applica60n/proposal control number
<br />assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-9o-001."
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<br />9. For a covered Federal acllon where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the awardl10an
<br />commitment for the prime enUty 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 enlity engaged by the reporting entity identified In item 4 to influence the covered
<br />Federal acUon,
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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 (MI).
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<br />11. Enter the amount of compensaUonpald or reasonablyexpectedto be paid by the reporting entity (Item 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 to be made.
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<br />12. Check the appropriatebox(es). Check all boxes that apply .If paymentis made through an In-kind contribution, specify the nature and valueof 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. Providea specific and detailed description of the services that the lobbyist has performed, or wID be expected to perform, and the date(s) of any services
<br />rendered. Include all preparatory and related activity, not just time spent In aelual contact with Federal officials. Identify the Federal offlcial(s) or
<br />employee(s) contacted or the offlcer(s), employee(s), or Member(s) of Congress that were conlac'ed.
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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, 60e, and telephone number.
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<br />According to the Paperwork Reduction Act, as amended, no persons are required 10 respond to a collection of Information unless it displays a valid OMS Control
<br />Number. The valid OMS control number for this Information collection is OMB 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 collection of Information. Send comments regarding the burden estimate or any other aspect of this collection of
<br />informatlon,lncludlng suggestions for reducing this burden, 10 the Office of Managementand Budget, Paperwork Reduction Project (0348-0046), Washington,
<br />DC 20503.
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