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Exh, D - MSA with Siemens <br />Attachment 1 Approved by oMa, <br />DISCLOSURE OF LOBBYING ACTIVITIES 0348-0048 <br />1. Type of Federal Action: <br />I "I Inli-lone .4 611 <br />2. Status of Federal Action: <br />3. Report Type: <br />Ela. contract <br />❑a. bid/offer/application <br />a. initial filing <br />In. grant <br />b. initial award <br />b. material change <br />c. cooperative agreement <br />c. post -award <br />For Material Change Only: <br />d. loan <br />year quarter <br />e. loan guarantee <br />date of last report <br />f. loan Insurance <br />4. Name and Address of Reporting Entity: <br />5. If Reporting Entity in No. 4 is a Subawardee, Enter Name <br />❑ Prime ❑ Subawardee <br />and Address of Prime: <br />Tier , Ifknown: <br />Coniciressional District: if known: 4o <br />Congressional District, Ifknown: <br />6. Federal Department/Agency: <br />7. Federal Program Name/Description: <br />CFDA Number, if appilcable: <br />S. Federal Action Number, if known: <br />9. Award Amount, If known: <br />$ <br />10. a. Name and Address of Lobbying Registrant <br />b. Individuals Performing Services (including address if <br />(if individual, last name, first name, Ml): <br />differant from No. 10a) <br />(last name, first name, MI): <br />11 Infcrmallon requested thmu0h We form Is anthi e l by Mlle 31 U.C. sectlon <br />1354. TNa dlscloaure of lobbying Mal is a man dal repreaddraton of fact <br />Signature• <br />upon mhIw reliance vas placed by dla bar above when this transaction was mads <br />or enured Into. ride rile Aware Is required pursuant to 31 10.8,c, 1352, Thin <br />print Name: <br />Ldmmallon wlllbeaValtableforpudlolnspedion. Mypeiean whalagstofde Ns <br />rewired biennial shell be aubleat b a civil penalty of not less than $10,0100 and <br />Title: <br />Telephone No.: Date: <br />nolmare Nan $100,000 rer each such 1 -OM. <br />for Local Reproduction <br />Federal Use Only:Authorized <br />, <br />Standard Form LLL(Rev. 7-97) <br />25®-33 <br />