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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 subawardee or prime Federal reclplent, at the Initiation or receipt of a covered Federal
<br />action, or a material change to a previous filing, pursuantto titie 31 U.S.C. sectlO? 1352. The filing of a fann Is required for each payment or agreementto make
<br />paymentto any lobbying entity for Influencing or attempting to Influence an officer or employee of any agency, a Member of Congress, an officer or employee of
<br />Congress, or an employeeof a Member of Congress In connection with a covered Federalacllon. Use the SF-LLLA ContinuationSheetfor additlonallnformationif
<br />the space on the form 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 addlllonallnformallon.
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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 acllon.
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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 information prevtously 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. Include Congressional District, If known. Check the appropriate classification
<br />of the reporting enllty that designates if it Is, or expects to be, a prime or subaward reciplenl.ldenllfy the ller of the subawardee. e.g., the first subawardee
<br />of the prime is the 1 st ller. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
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<br />5. If the organlzallon 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. .
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<br />6. Enter the name of the Federal agency making the award or loan commitment. Include at least one o..gilnlzationallevel below agencyname, 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 acllon (item 1). If known, enter the full Catalog of Federal Domesllc Assistance
<br />(CFDA) number for grants, cooperative agreements, loans, and loan comm:tments.
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<br />8. Enter the most appropriate Federal idenllfylng number available for the Federal action idenllfied 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."
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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 awardlloan
<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 Influence the covered
<br />Federal acllon.
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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 Inillal (MI).
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<br />11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying enllty (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, enter the cumulallve
<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 payment is made through an In-kind contribution, specify the nature and value of the In-kind
<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. Provide a specific and detailed description of the services that the lobbyist has performed, or will 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 Federalofficlals. Idenllfy the Federalofficlal(s) or
<br />employee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacted.
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<br />15. Check whether 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, title, and telephone number.
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<br />According to the Paperwork Reducllon Act, as amended, no persons are required to respond to a collecllon 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 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 collecllon of Information. Send comments regarding the burden estimate or any other aspect of this collection of
<br />Information,lncludlng suggestions for reducing this burden, to the Office of Managementand Budget, Paperwork Reducllon Project (0348-0046), Washington,
<br />DC 20503.
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