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7 <br /> • <br /> • <br /> INSTRUCTION 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 initiation or receipt of a covered Federal <br /> action,or a material change to a previous filing,pursuant to title 31 U.S.C.section 1352. The filing of a form is required for each payment or agreement to make <br /> payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of <br /> Congress,or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation Sheet for additional information <br /> if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance <br /> published by the Office of 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 outcome of <br /> a covered 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 <br /> to the information previously reported, enter the year and quarter in which the change occurred. Enter the <br /> date of the last 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, <br /> if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a <br /> prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the <br /> 1st tier. Subawards include but at not limited to subcontracts,subgrants and contract awards under grants. <br /> 5. Of the organization filing the report in item 4 checks "Subawardee", then enter the full name, address, city, <br /> state, and 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). 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 award <br /> number;the application/proposal control number assigned by the Federal agency). Include 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 <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 entity engaged by the report <br /> 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 <br /> 10(a). 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 to be <br /> made. <br /> 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind <br /> contribution,specify the nature and value of the in-kind payment. <br /> 13. Check the appropriate box(es). Check all boxes that apply, If other,specify nature. <br /> 14. Provide a specific and detailed description of the service that the lobbyist has performed,or will be expected to perform, <br /> and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent <br /> in actual contact with Federal officials. Identify the Federal official(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-LLL-A 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 /> Public reporting burden for this collection of information is estimated to average 30 minutes per response,including time for reviewing instructions,searching <br /> existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the <br /> burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget, <br /> Paperwork Reduction Project(0348-0046),Washington D.C.20503. <br /> Federal Register/Vol.54,No.243/Wednesday,December 20,1989/Notices 52325 <br /> DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB <br /> / CONTINUATION SHEET 0348-0046 <br /> 64 <br /> Page 3 of 4 1W312003 p:lctty of everett home 2003 it2\attochment g-lobbying.doclsma <br />