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<br />Disclosure of Lobbying Activities <br />Instructions for Completion of SF-LLL, Disclosure of Lobbying Activities (cont'd) <br /> <br />.-'..pproved by m,,[B <br />0343-0046 <br /> <br />(.1.5 am~nd~d) <br /> <br />Complete this form to disclose lobbying activities pursuant to 31 u.s.e. 1352 <br />(See reverse for instructions and public burden disclosure) <br /> <br />1. Type of Federal Action: <br />a. contract <br />b. grant <br />c. cooperative agreement <br />d. loan <br />e. loan guarantee <br />f. loan insurance <br /> <br />B <br /> <br />2. Status of Federal Action: <br />a. bid/offer/application <br />b. initial award <br />c. post-award <br /> <br />A <br /> <br />3. Report Type: ~ <br />a. initial filing <br />b. material change <br /> <br />For AIaterial Change Only: <br />Year: <br />Quarter: <br />Date of last report <br /> <br />4. Name and Address of Reporting Entity: <br />CXPrime 0 Subawardee <br />Tier _, if known: <br /> <br />5. If Reporting Entity in No.4 is Subawardee, Enter <br />Name and Address of Prime: <br /> <br />City of San Marcos <br /> <br />Congressional District (number). if known: -1...:L <br /> <br />Congressional District (number). if known: _ <br /> <br />6. Federal Department/Agency: <br /> <br />United State~ Department of <br />Justice <br /> <br />7. Federal Program NamelDescription: <br /> <br />CFDA Number, if applicable: 16. 710 <br /> <br />8. Federal Action Number, if known: <br /> <br />9. Award Amount, if known: <br /> <br />s <br /> <br />10. a. Name and Address of Lobbying Registrant <br />(if individual. last name. first name, AI!): <br /> <br />10. b. Individuals Performing Services <br />(including address if different from No.! Oa) <br />(last name, first name, MI): <br /> <br />11. lnfurmation requested through this form is author-- <br />ized by Trt:1e 31 USe. Section 1352. This disdosure of <br />lobbying activities is a material representation of fad: <br />upon which reiiance was placed by the tier above wf1erI <br />this transaction was made or entered intD. This disdo- <br />sure is required pursuant to 31 USe. 1352. This infor- <br />mation will be reported to the Congress semi-annually <br />and will be available for public inspedion. Any person <br />who fails to file the required disdosure shall be subject <br />to a civil penalty of not less than $10,000 and not more <br />than $100,000 for eadt sudl failure. <br /> <br />Signature: <br /> <br /> <br />Print Name: <br /> <br />Title: <br /> <br />City Manaqer <br /> <br />Telephone No.: 512-393-8000 <br /> <br />Date: 1-//-01 <br /> <br />Federal Use Only: Authorized for Local Reproduction, St2ndard Form - LLL <br /> <br />70 <br /> <br />Section VIII - You must return this page as part o[your application <br />