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Authorized for Local Reproduction
<br />Standard Form - LLL-A
<br />INSTRUCTION FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
<br />This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the Initiation or receipt of a
<br />covered Federal 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
<br />payment or agreement to make payment to any lobbying entity for Influencing or attempting to Influence an officer or employee of any agency, a
<br />Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress In connection with a covered Federal action.
<br />Use the SF-LLL-A Continuation Sheet for additional Information If the space on the form Is Inadequate. Complete all Items that apply for both the
<br />Initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional
<br />Information.
<br />1. Identity the type of covered Federal action for which lobbying activity is andlor has been secured to influence the outcome of a
<br />covered Federal action.
<br />2. Identify the status of the covered Federal action.
<br />3. Identify the appropriate classification of this report. If this Is a followup report caused by a material change to the Information
<br />previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted
<br />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. Check the
<br />appropriate classification of the reporting entity that designates If It Is, or expects to be, a prime or subaward recipient. Identify
<br />the tier of the subawardee, e.g., the first subawardee of the prime is the let tier. Subawards Include but are not limited to
<br />subcontracts, subgrants and contract awards under grants.
<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
<br />the prime Federal recipient. Include Congressional District, If known
<br />6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below
<br />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 Catalog of Federal
<br />Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.
<br />8. Enter the most appropriate Federal Identifying number available for the Federal action identified In Item 1 (e.g., Request for
<br />Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number;
<br />the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001:"
<br />9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal
<br />amount of the awardiloan commitment for the prime 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 identified In
<br />item 4 to Influence the covered Federal action.
<br />(b) Enter the full name of the Individual(s) performing services, and Include full address If different from 10 (a). Enter Last
<br />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 lobbying entity
<br />(item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this Is
<br />a material change report, enter the cumulative amount of payment made or planned to be made.
<br />12. Check the appropriate box(es). Check all boxes that apply. If payment Is made through an in-kind contribution, specify the
<br />nature and value of the in-kind payment.
<br />13. Check the appropriate box(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 perform, and
<br />the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with
<br />Federal officials. Identify the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s) of
<br />Congress that were contacted.
<br />15. Check whether or not a SF-LLL-A Continuation Sheet(s) Is attached.
<br />16. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
<br />Public reporting burden for this collection of information Is estimated to average 30 minutes per response, Including time for reviewing
<br />Instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
<br />Information. Send comments regarding the burden estimate or any other aspect of this collection of Information, Including suggestions for
<br />reducing this burden, to the Office of Management and Budgets. Paperwork Reduction Project (0348-0046), Washington, D.C. 20503.
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