BOSCH, WESLEY A. 16 - 2014 - Laserfiche WebLink

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DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348 -0046 (See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑ a. contract ❑ a. bid /offer /application ❑ a. initial filing b. grant b. initial award b. material change c. cooperative agreement c. post -award For Material Change Only: J. loan year quarter e. loan guarantee date of last report f. loan insurance 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address ❑ Prime ❑ Subawardee of Prime: Tier_, if known: Congressional District, if known: Congressional District, if known: 6. Federal Department /Agency: 7. Federal Program Name /Description: CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobbying b. Individuals Performing Services ( including address Entity ( if individual, last name, first name, MI): if different from No. 10a) (last name, first name, MI): (attach Continuation Sheets) SF -LLLA, if necessary) 11. Amount of Payment ( check all that apply): 13. Type of Payment ( check all that apply): $ ❑ actual ❑ planned ❑ a. retainer ❑ b, one -time fee E3 c. commission [-I d . contingent fee 12. Form of Payment ( check all that apply): [1] a. cash ❑ e. deferred ❑ b. in -kind; specify: nature ❑ f. other; specify: value 14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Members) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) SF -LLLA, if necessary ) 15. Continuation Sheet(s) SF -LLLA attached: Yes ❑ No a _ 16. Signature: Information requested through this form is authorized by title 31 Print Name: 4L' -> ` ' 5 C'- s- U.S.C. section1352. This disclosure of lobbying activities is a l Title: —C material representation of fact upon which reliance was placed Telephone No.: Date: 2 I by the tier above when this transaction was made or entered L� into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi - annually and / %j >/ `C,'L�(�r e will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of notGz less that $10,000 and not more than $100,000 for -- ; G lL� •dL^�' 4%- each such failure. Authorized for Local Reproduction Federal Use Only: Standard Form LLL Rev. 7 -97 EXHIBIT 6