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<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 agreement to make
<br />paymenito 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 Member of Congress in connectionwith a covered Federal action. Use the SF-LLLA Continuation Sheet for additional Information if
<br />the space on the form is inadequate. Complete all items that apply for both the initial ailing and material change report. Refer to the implementing guidance
<br />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 classif!cation 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 appropriateclassification
<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 descriptlon 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 awardAoan
<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 entity engaged by the reporting entity identified in item 4 to influence the covered
<br />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, Enter the amount of compensation paid or reasonablyexpectedto be paid by the reporting entity(item 4) to the lobbying entity (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 cumulative
<br />amount of payment made or planned to be made.
<br />12, Check the appropriatebox(es). Check all boxes that apply. If paymentis made through an in -kind contribution, specify the nature and value of the in -kind
<br />payment.
<br />13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.
<br />14. Providea 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 Federal officials. Identify the Federal official(s) or
<br />employee(s) contacted or the offlcer(s), employee(s), or Member(s) of Congress that were contacted.
<br />15. Check whether or not a SF-LLLA 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 />According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OM3 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 average30 minutes per response, including time for reviewing instructions, searching oxisfing 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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