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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 loom 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 1351.The tiling of a fonm is required foe 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.ILI-A Continuation Sheet for additional information if the space on the lam is inadequate.Complete all items that <br /> apply for both the initial filing and material change report-Refer to the Implementing guidance published by the Office of <br /> Management and Budget for additional inionmatton. <br /> 1. Identify the type of covered Federal action for which lobbying activity Is andror has been secured to influence the <br /> e outcome of a covered Federal action. <br /> 1. Identity 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 /> 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 rip 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.Identity the tier of the subawardee,e.g.,the first subawardee of the prime is the 1st tin. <br /> Subawards include but art not limited to subcontracts.subgrants and contract awards under grants. <br /> 5. If the organization filing the report in item 4<herks"Subawadee",then enter the full name.address,city,state and <br /> zip code of the prime Federal recipient.include Congressional District,it known. <br /> b. 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 Slates Coast Ceaard. <br /> 7. Enter the federal program name or description for the covered Federal action(item 11. If known,enter the full <br /> Catalog of Federal Domestk Assistance(CFOA)number for grants, cooperative agreements, loans, and loan <br /> commitments. <br /> g. Enter the most appropriate Federal identifying number available for the Federal action identified In itom I(e.g., <br /> Request for Proposal OOP)number;Invitation for Bid(IFS)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 OE.90-O01." <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 award3oan commitment for the prime entity identified in item a or 5. <br /> 10. (a/Enter the full name,address,city,state and zip code of the lobbying entity engaged by the reporting entity <br /> identified in Rem 4 to influence the covered Federal action. <br /> (hi/Enter the fug names of the individuals)performing services,and include lull address if different horn 10 la). <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 Own It to the <br /> lobbying entity(item 10). Indicate whether the payment has been made tactual)or will be made(planned). Check <br /> all boxes that apply. If this is a material change report,enter the cumulative annomt of payment made or planned <br /> to be made. <br /> 12. Check the appropriate bodes).Check all bores that apply.If payment is made through an imkind contribution, <br /> specify the nature and value of the behind payment. <br /> 13. Check the appropriate boxles). 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 svil be expected to <br /> perform,and the dalets)o any services ordered.Include all preparatory and reined activity,not just time spent in <br /> actual contact with Federal officials. Identify the Federal offioalls)or employees)contacted or the officeds>. <br /> employee(s),or Mernberls)of Congress that were contacted. <br /> 15, Check whether or not a SF'LIL-A Continuation Sheet(s>is attached. <br /> lb.The certifying official shall sign and date the form.prim higher name,title,and telephone number. <br /> Iubkc repotting burden for dm collection of infonnapon a estimated to rage 30 winnow pet respsns..:nektons rime for reviewing <br /> lawucsans.ward ng mains data sources gathering and marnaimng the data needed,and composing and reviewing the cdecaon d <br /> information Send comments rryadrrg due burden esonrace or any other aspect at din collection of infoensaiw,including suggestions <br /> for reducing this Carden,to Mr Offka of aaanaaenrni and Midges.Paperwmt Redurrnn nowt(o3ae-00.4.Washington,D.C.)0503 <br /> 263 <br />