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DocuSign Envelope ID.A8C762C9-928E-48B7-A713-EBD8AD177926
<br /> INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
<br /> This disclosure form must be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation
<br /> or receipt of a covered Federal action,or a material change to a previous filing,pursuant to title 31 U.S.C.section 1352. The filing
<br /> of a form is required for each paymentor agreementto make paymentto any lobbying entity for influencing or attemptingto
<br /> influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of a
<br /> Member of Congress in connectionwith a covered Federal action.Complete all items that applyfor both the initial filing and
<br /> material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional
<br /> 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
<br /> a 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 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 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
<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 loan
<br /> award number; the application/proposal control number assigned by the Federal agency). Include prefixes,e.g.,"RFP-DE-
<br /> 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 registrant under the Lobbying Disclosure Act of
<br /> 1995 engaged by the reporting entity identified 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 Last
<br /> Name,First Name,and Middle Initial(MI).
<br /> 11. The certifying official must 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 OMB Control Number.
<br /> The valid OMB control number for this information collection is OMB No.0348-0046. Public reporting burden for this collection of information is estimated to
<br /> average 10 minute',per response,including time for reviewing instructions, searching existing data sources,gathering and maintaining the data needed,and
<br /> completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
<br /> including suggestions for reducing this burden,to the Office of Managementand Budget,Paperwork Reduction Project(0348-0046),Washington,DC 20503.
<br /> O!P FORM 4000/2(REV.4-88)
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