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INSTRUCTIONS FOR COMPLETION OF SF -LLL, DISCLOSURE OF LOBBYING ACTIVITIES
<br />This disclosure form shall be completed by the reporting entity, whether subawardeeor prime Federal recipient, at the Initiation or receipt of a covered Federal
<br />action, or a materialchange to a previous fling, pursuant to We 31 U.S.C. section 1352. The filing of a form is required for each paymentor agreementto make
<br />payment to any lobbying entity for Influencing or attempting to Influence an officer cr employeeof any agency, a Member of Congress, an officer or employeeof
<br />Congress, oran employeeof a Memberof Congress in connectionwith a covered Federal action. Completeall Items that applyfor both the Initial filing and material
<br />change report. Refer to the implementing guidance published by the Offco of Management and 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 covered Federal action.
<br />2. Identify the status of the covered Federal action.
<br />3. Identify the appropriate cfassiflcation of this report. If [his 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 />action.
<br />4. Enter the full name, address, city, Stale and zip code of there porting enOty. include Congresslonal District, If known, Check the appropriateclasslflcalion
<br />of the reporting enilty that designates If It Is, or expects to be, a prime or subaward reciplent. Identify the tier of the subawardee, e.g., the first subawardee
<br />of the prime Is the 1st Oer. Subawards include but are not limited to 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 the prime Federal
<br />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 organizatlonallevel below agency name, if known. For
<br />example, Department of Transportation, United States Coast Guard.
<br />7. Enter the Federelprogram name or description for the covered Federal action (Rem 1). If known, enter the full Catalog of Federal Domestic Assistance
<br />(CFDA) number for grants, cooperative agreements, loans, and loan commitments.
<br />8. 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 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•90-001."
<br />9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan
<br />commitment for the prime entity identified in Item 4 or S.
<br />10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting
<br />entity identified in item 4 to Influence 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 Name, First Name, and
<br />Middle Initial (MI).
<br />11. The certifying official shall sign and date the form, print hislher name, title, and telephone number.
<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 OMB 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 10 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, Paperwork Reduction Prefect (0348-0046), Washington,
<br />DC 20503.
<br />25D-34
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