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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, whether subawardeeor prime Federal recipient. al the initiation or receipt of a covered Federal
<br />action, or a material 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 agreement to make
<br />payment to any lobbying entity for influencing or attempting to influence an officer or employeeof any agency. a Member of Congress, an officer or employee of
<br />Congress, or an employeeof a Memberof Congress in connection with a covered Federal action. Use the SF.LLLA ConlinuationSheetfor additional informalion if
<br />the space on the (ann 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 activity 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 appropriate classification of this report. If this Is a followup report caused by a material change to the infonnalion 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 />action.
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<br />4. Enter the full name, address, city. State and zip code of the reporting entity.lnctude Congressional District, if known. Check the appropriateclassificalion
<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 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,Mthen 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. Enter the name of the Federal agency making the award or loan commilmenllnclude at least one organlzatlonallevel below agency name. if 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 />8. Enter the most appropriate Federal Identifying number availablefor the Federal action Identffled In Item 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 prefixes, e.g., .RFP~DE-90~1. If
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<br />9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award1loan
<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 inftuence 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 (MI).
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<br />11. Enter the amountof compensation paid 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, enler 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~lnd
<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 wlH be expected to perform, and the date(s) of any services
<br />rendered. Include all preparatory and related activity, not Just time spent In actual contact with Federal officials. Identify the Federal official(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 whethar 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, DUe. 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 valid OMS Control
<br />Number. The valid OMB 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 />information. including suggestions for reducing this burden, to the OffIce of Managementand Budget, PspetWOrk Reduction Project (0348-0046), Washington,
<br />I DC 20503.
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