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3/24/2022 Landmark Web Official Records Search
<br /> 202109300425 Document:COVENANTS Rec: $220.50 Page-12 of 18
<br /> Record Date:9/30/2021 12:45 PM Snohomish County,WA
<br /> INSTRUCTIONS 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
<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
<br /> for influencing or attempting to fluence an officer or employee of any agency,a Member of Congress,an officer or
<br /> employee of Congress,ormptoyee of a Member of Congress in connection with a covered Federal action.
<br /> Complete all items that ap." fopOth the initial filing and material change report. Refer to the implementing guidance
<br /> published by the Office of hilrefent and Budget for additional information.
<br /> 1. Identi the fy type of covered*wet action for which lobbying activity is and/or has been secured to influence the
<br /> outcome of a covered Federal actldb.
<br /> 2. Identify the status of the covered fiction.
<br /> 3. Identify the appropriate classificatio o ht report. If this is a follow-up report caused by a material change to the
<br /> information previously reported,enterWg(and quarter in which the change occurred.Enter the date of the last
<br /> previously submitted report by this repor( ''e City for this covered Federal action.
<br /> 4. Enter the full name,address,city, State a 10•.code of the reporting entity.Include Congressional District,if
<br /> known.Check the appropriate classification. ' sporting entity that designates if it is,or expects to be,a prime
<br /> or sub-award recipient. Identify the tier of the t�iwardee,e.g.,the first sub-awardee of the prime is the 1st tier.
<br /> Sub-awards include but are not limited to subcontracts,s -grants and contract awards under grants.
<br /> 5. If the organization filing the report in item 4 checks ub' wardee,"then enter the full name,address,city,State
<br /> and zip code of the prime Federal recipient.Include CO4144sional District,if known.
<br /> 6. Enter the name of the Federal agency making the award orlpa, commitment.Include at least one organizational
<br /> level below agency name,if known.For example,Departmt o,T,ransportation,United States Coast Guard.
<br /> � v
<br /> 7. Enter the Federal program name or description for the cover` ,, eral action(item 1).If known,enter the full
<br /> ,to ,
<br /> Catalog of Federal Domestic Assistance(CFDA)number for ,ooperative agreements,loans,and loan
<br /> commitments.
<br /> 8. Enter the most appropriate Federal identifying number available for tf1 fegeral action identified in item 1 (e.g.,
<br /> Request for Proposal(RFP)number,Invitation for Bid(IFB)number;gl announcement number;the contract,
<br /> grant,or loan award number;the application/proposal control number assig (•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 commi i ant by the Federal agency,enter
<br /> the 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,State and zip code of the lobbying registrant under the Lobbying Disclosure
<br /> Act of 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
<br /> Last Name,First Name,and Middle Initial(MI).
<br /> 11.The certifying official shall 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
<br /> displays a valid OMB Control Number. The valid OMB control number for this intonation collection Is OMB No.0348.0046.
<br /> Public reporting burden for this collection of information is estimated to average 30 minutes per response,including time for
<br /> reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing
<br /> 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 Management and Budget,Paperwork Reduction Project(0348-
<br /> 0046),Washington,DC 20503.
<br /> Exhibit H
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<br /> Housing Hope
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