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Authorized for Local Reproduction
<br /> Standard Form -LLL-A
<br /> INSTRUCTION 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
<br /> covered Federal 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
<br /> payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a
<br /> Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action.
<br /> Use the SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the
<br /> initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional
<br /> information.
<br /> 1. Identity the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a
<br /> 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 to the information
<br /> previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted
<br /> 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 the
<br /> appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify
<br /> the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to
<br /> 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
<br /> 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 below
<br /> 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 Federal
<br /> 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 for
<br /> Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number;
<br /> the application/proposal control number 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
<br /> amount of the award/loan 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
<br /> item 4 to influence the covered Federal action.
<br /> (b) Enter the full name of the individual(s) performing services, and include full address if different from 10 (a). Enter Last
<br /> 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 entity
<br /> (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is
<br /> a material change report, enter the 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 the
<br /> 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, and
<br /> the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with
<br /> Federal officials. Identify the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s) of
<br /> 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.
<br /> Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing
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<br /> instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
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<br /> information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
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<br /> reducing this burden, to the Office of Management and Budgets. Paperwork Reduction Project (0348-0046), Washington, D.C. 20503.
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