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<br />'wi <br /> <br />Instructions for Completion of SF-LLL, l1i"..bsure of Lobbying Activities <br /> <br />This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt <br />of a covered Federal action, or a material change to a previous filing, pursuant to tiUe 31 U.S.C. section 1352. The filing of a form is required <br />for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee <br />of any agency, a Member of Congress, an officer or employee of Congress, or any employee of a Member of Congress in connection with <br />a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing <br />guidance published by the Office of Management and Budget for additional information. <br /> <br />1. Identify the type of covered Federal action for which lobbying <br />activity is and/or has been secured to influence the outcome <br />of a covered Federal action. <br /> <br />2. Identify the status of the covered Federal action. <br /> <br />3. Identify the appropriate classification of this report. If this is a <br />followup report caused by a material change 'to the informa- <br />tion previously reported, enter the year and quarter in which <br />the change occurred. Enter the date of the last previously <br />submitted report by this reporting entity for this covered <br />Federal action. <br /> <br />4. Enter the full name, address, city, state and zip code of the <br />reporting entity. Include Congressional District, if known. <br />Check the appropriate classification of the reporting entity <br />that designates if it is, or expects to be, a prime or subaward <br />recipient. Identify the tier of the subawardee, e.g., the first <br />subawardee of the prime is the 1st tier. Stibawards include,but <br />are notlimited to subcontracts, subgrants and contract awards <br />under grants. <br /> <br />5. If the organization filing the report in item 4. checks <br />"Subawardee", then enter the full name, address, city, fltate <br />and zip code of the prime Federal recipient, Include Congres- <br />sional District, if known. <br /> <br />6. Enter the name of the Federal agency making the award or <br />loan commitment. I nclude at least one organizational level <br />below agency name, if known. For example, Department of <br />Transportation, United States Coast Guard. <br /> <br />7. Enter the Federal program name or description for the cov- <br />ered Federal action (item 1).11 known,. enter the full Catalog of <br />Federal Domestic Assistance (CFDA) number for grants, <br />cooperative agreements, loans, and loan commitments. <br /> <br />8. Enter the most appropriate Federal identifying number avail- <br />able for the Federal action identified in item 1 (e.g., Request <br />for Proposal (RFP) number; Invitation for Bid (IFB) number; <br />grant announcement number; the contract, grant, or . loan <br />award number; the application proposal control number as- <br />signed by the Federal agency). Include prefixes, e.g., "RFP- <br />DE-90-001." <br /> <br />9. For a covered Federal action where there has been an award <br />or loan commitment by the Federal agency, enter the Federal <br />amount of the award/loan commitment for the prime entity <br />identified in item 4 or 5.' .. <br /> <br />10. (a) Enter the full name, address, city, state and zip code of the <br />. registrant under the Lobbying Disclo$ureAct 011995 engaged <br />by the reporting entity identified in item 4 to influence the <br />covered Federal action. <br /> <br />(b) Enter the full names of the Individual(s) performing ser- <br />vices, and include full address if different from 10 (a). Enter <br />Last Name, First Name, and Middle Initial (MI). <br /> <br />11. Enter the amount of compensation paid or reasonably ex- <br />pected to be paid by the reporting entity (item 4) to the <br />lobbying entity (item 10). Indicate whether the payment has <br />been made (actual) or will be made (planned). Check all <br />boxes that apply. If this is a material change report, enter the <br />cumulative amount of payment made or planned to be made. <br /> <br />12, Check the appropriate box (es). Check.all boxes that apply. , <br />If payment is made through an in-kind contribution, specify the <br />nature and value of the in-kind payment. <br /> <br />13. Check the appropriate box (es). Check all boxes that apply. <br />If other, specify nature. <br /> <br />14. Provide specific and detailed description of the services that <br />the lobbist has performed, or will be expected to perform, and <br />the date(s) of any services rendered. Include all preparatory <br />and related activity, not just the time spent in actual contact <br />with Federal officials. Identify the Federal offlcial(s) or <br />employee(s) contacted or the officer(s), employee(s), or <br />Member(s) of Congress that were contacted. <br /> <br />15. Check whether or not a continuation sheet(s) are attached. <br /> <br />16. The certifying official shall sign and date the form, print his/her <br />name, title, and telephone number. <br /> <br />Public Reporting Burden for this collection of information is estimated to average 30 minutes per response., including the time for reviewing Instructions, <br />searching existing data sources, gathering and maintaining the data needed, and completing and reViewing the collection of information. Please do not <br />return your completed form to the Office of Management and Budget; send It to the address provided by the sponsoring agency . <br />Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the <br />Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503. <br /> <br />Authorized for Local Reproduc~lon <br />Standard Form-LLL (7/97) <br /> <br />ATTACHMENT I TO EXHIBIT C -- PAGE 20f 2 <br />