Laserfiche WebLink
Page 24 of 26 <br />Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered <br />Federal action. <br />(b)Enter the full names of the individual(s) performing services, and include full address if different from <br />10 (a). Enter Last 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. The <br />valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 <br />minutes per response, including time for 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, including suggestions for reducing this <br />burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503. RFP