|
EXHIBIT 10 -Q Local Assistance Procedures Manual
<br />Disclosure of Lobbying Activities
<br />INSTRUCTIONS FOR COMPLETION OF SF -LLL,
<br />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
<br />covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for
<br />such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any
<br />agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered
<br />federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply
<br />for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and
<br />Budget for additional information.
<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
<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 follow -up 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 the
<br />tier of the subawardee, e.g., the first subawardee of the prime is the first 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 organization 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 identification 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 amount
<br />of the award /loan commitments 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 Item
<br />4. to influenced the covered federal action.
<br />(b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last
<br />Name, First Name and Middle Initial (Ml).
<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 the
<br />date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal
<br />officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that
<br />were contacted.
<br />15. Check whether or not 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 />instruction, 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 Budget, Paperwork Reduction Project (0348- 0046), Washington, D.C. 20503.
<br />SF- LLL - Instructions Rev.06- 04- 90«ENDIF»
<br />Page 10 -78
<br />May 1, 2006 LPP 06 -02
<br />
|