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<br />EXHIBIT H
<br />Page 1 of 3
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<br />Exhibit H
<br />6744 Federal ReQister Volume 55. No. 38/ Mondav. Februarv 26.1990/ Rules and ReQulations
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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 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. section
<br />1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing
<br />or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress.
<br />or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation sheet
<br />for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and
<br />material change report. Refer to the implementing guidance published by the Office of Management and Budget for
<br />additional information.
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<br />1. Identify the type of covered Federal action for which lobbying is and has been secured to influence the outcome of a
<br />covered action.
<br />2. Identify the status of the covered Federal action.
<br />3. Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the
<br />information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last
<br />previously submitted report by 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. if known. Check
<br />the appropriate classification of the reporting entity that designates if it is. or expects to be a prime or subaward recipient.
<br />Identify the tier of the subawardee, e. g. the first subawardee of the prime is the 1st tier. Subawards include but are not
<br />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
<br />code of the prime Federal 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
<br />below agency name, if known, For 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
<br />Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments.
<br />8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e. g. Request
<br />for Proposal (RFP) number; Invitation for Bid (IFB) number: grant announcement number the contract, grant. or ioan award
<br />number; the application proposal control number assigned by the Federal agency). Include prefixes, e.g" "RFP-DE-90-09."
<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 ofthe award/loan commitment for the primary 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
<br />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
<br />Last Name, First Name, and Middle Initial (MI).
<br />11, Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying
<br />entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply,
<br />If this is a material change report enter he cumulative amount of payment made or planned to be made.
<br />12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify
<br />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 perform.
<br />and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact
<br />with Federal officials. Identify the Federal official(s) or employee(s) contacted and the officer(s), employee(s), or Member(s)
<br />of Congress that were contacted,
<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.
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<br />Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for
<br />reviewing instructions. searching existing data sources, gathering and maintaining the data needed, and completing and
<br />reviewing the collection of information. Send comments regarding 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
<br />Reduction Project (0348-0046) Washington D. C., 20503,
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