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Docusign Envelope ID:3EDD0960-FFF6-43E2-8E49-1A7B2008A238
<br /> INSTRUCTIONS 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 covered Federal
<br /> 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 payment or agreementto make
<br /> payment to any lobbying entity for influencing or attempting to influence an officer or employeeof any agency,a Member of Congress,an officer or employeeof
<br /> Congress,or an employeeof a Memberof Congress in connection with 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 Office 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 classification of this report. If this 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,State and zip code of the reporting entity.Include Congressional District, if known.Check the appropriate classification
<br /> of the reporting entity that designates if it is,or expects to be,a prime or subaward recipient.Identify the tier of the subawardee,e.g.,the first subawardee
<br /> of the prime is the 1 st tier. 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 organizational level below agency name,if known.For
<br /> 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 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 5.
<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 his/her 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 Project(0348-0046),Washington,
<br /> DC 20503.
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