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<br /> INSTRUCTION FOR COMPLETION OF SF-LLL, DISCLOSURE I Do I!- <br /> OF LOBBYING ACTIVITIES <br /> This disclosure form shall be completed by the reporting entity, whether subawar~ or prime Federal recipient, at the <br /> initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. <br /> section 1352. The filing of a fo~ is required for each payment or agreement to me~e payment to any lobbying entity for <br /> inquiring or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of <br /> Congress, or an employ~ of a Member of Congress in connection with a covered Federal action. Use the SF-lll'A Continuation <br /> Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial <br /> filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for <br /> additi~l information. <br /> 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence <br /> 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 <br /> to the information previously reported, enter the year and quarter in which the change <br /> occurred. Enter the date of the last previously s~itted report by <br /> this reporting entity for this covered Federal action. <br /> 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, <br /> if known. Check the appropriate classification of the reporting entity that <br /> designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the <br /> first subawar~ of the prime is the 1st tier. Subawards include but are <br /> 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, <br /> state and zip code of the prime Federal recipient. Include Congressional <br /> District, if known. <br /> 6- Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational <br /> level belO'./ agency name, if known. For example, Department of Transportation, United <br /> States Coast Guard. <br /> 7. Enter the Federal program name or description for the covered Federal action (item 1). I f known, enter the full <br /> Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative <br /> agr~ts, loans, and loan commitments. ~ <br /> 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 <br /> (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFS) number, grant <br /> announcement number, the contract, grant, or loan award number; the application/propOsal control number assigned by <br /> the Federal agency). Include prefixes, e.g., "RFP-Oe-9Q-OO1." <br /> 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the <br /> Federal amount of the award loan commitment for the prime entity identified in Item 4 or <br /> 5. <br /> 10. (a) Enter the full nane, address, city, state and zip code of the lobbying entity engaged by the reporting entity <br /> identified in item 4 to influence the covered Federal action. <br /> (b) Enter the full names of the individuates) performing services, and include full address if different from 10(a). <br /> Enter Last Name, First ~ame, and Middle Initial (HI). <br /> 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the <br /> lobbying entity (itent 10). Indicate whether the payment has been made (actual) or <br /> will be made (plalY"led). Check all boxes that apply. If this is a material change report, enter the cl.m.llative amount <br /> of payment made or plamed to be made. <br /> 12. Check the appropriate bo~(es). Check all bo~es that apply. If payment is made through an in-kind contribution, <br /> specify the nature and value of the in-kind payment. <br /> 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. <br /> 14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to <br /> perform, and the date(s) of any services rendered. Include all preparatory and <br /> related activity, not just time spend in actual contact with Federal officials. Identify the Federal official(s) or <br /> employee(s) contacted or the officer(s), employee(s) , or Member(s) of Congress <br /> that were con.acted. <br /> 15. Check whether or not a SF-LLL'A Continuation Sheet(s) is attached. <br /> 16. The certifying official shall sign and date the form, print his/her name, title, and telephone number. <br /> Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time <br /> for revie-.¡ing instructions, searching existing data sources, gathering and lMintaining the data needed, and completing and <br /> revie-.¡ing the collection of information. Sere:! Cannef'lts re<3arding the burden estimate or any other aspect of this collection <br /> of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction <br /> Project (0348-0046), ~ashington, D.C. 20503. <br />