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Office of the Secretary of the Treasury Pt.21,App.B
<br /> INSTRUCTIONS FOR COMPLETION OF SF-LLL,DISCLOSURE OF LOBBYING ACTIVITIES
<br /> This disclosure Torn 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.
<br /> section 1352.The filing of a form is required for each payment or agreement to make payment to any lobbying entity for
<br /> Influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or
<br /> employee of Congress,or an employee of a Member of Congress In connection with a covered Federal action.Use the
<br /> SF-LLL-A Continuation Sheet for additional information If the space on the form is Inadequate.Complete all Items that
<br /> apply for bolts the Initial filing and material change report.Refer to the Implementing guidance published by the Office of
<br /> Management and Budget for additional Information.
<br /> 1. Identify the type of covered Federal action for which lobbying activity Is and/or has been secured to influence the
<br /> outcome of 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 followup report caused by a material change to the
<br /> inlarnatlon 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
<br /> known.Check the appropriate classification of the reporting entity that designates If if is,or expects to be,a prime
<br /> or subaward recipient.Identify the der of the subawardee,e.g.,the first subawardee of the prime is the 1s1 tier.
<br /> Subawards Include but are not 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
<br /> zip 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
<br /> level 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). II known,enter the lull
<br /> Catalog of Federal Domestic Assistance(CFDA)number for grants, cooperative agreements, loans, and loan
<br /> commitments.
<br /> 8. Enter the most appropriate Federal Identifying number available for the Federal action Identified in Item 1(e.g.,
<br /> Request for Proposal(RN')number;Invitation for Bid(IFB)number,grant announcement number,the contract,
<br /> grant,or loan award number,the application/proposal control number assigned by the Federal agency). Include
<br /> 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
<br /> Federal 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,stale and zip code al the lobbying entity engaged by the reporting entity
<br /> 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 horn 10(a).
<br /> Enter 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
<br /> lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made(planned). Check
<br /> all boxes that apply. If this Is a material change report,enter the cumulative amount of payment made or planned
<br /> to be made.
<br /> 12. Check the appropriate box(es).Check all boxes that apply.It payment is made through an In•hind contribution,
<br /> specify the nature and value of the In-kind payment.
<br /> 13.Check the appropriate box(es).Check all boxes that apply.II other,specify nature.
<br /> 14. Provide a specific and detailed description of the services that the lobbyist has performed,or will be expected to
<br /> perform,and the date(s)of any services rendered.Include all preparatory and related activity,not lust time spent in
<br /> actual contact with Federal officials.Identify the Federal offidal(s)or employee(s)contacted or the officer(s),
<br /> employee(s),or Member(s)of Congress that were contacted.
<br /> • 15.Check whether or not a SF-LLLUA 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 /> Pubtk reporting harden for this collection of information Is estimated to average 30 mimes per response,Including time for reviewing
<br /> instructions,scathing misting data scam,gathering and mdnulning the data needed,and completing and reviewing the collection of
<br /> lelotmatton.Send comments regarding the burden estimate or soy other aspect of tits collection of Information,Indic ia%suggestions
<br /> for sedudre this burden.to the Office of Manyement and Budget.Paperwork Reduction Project(0348-0046),Washington,O.C.30503.
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