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DocuSign Envelope ID:B92DDOFA-B451-4722-ACC3-D65CAA5BDAEC
<br /> Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a
<br /> covered Federal action.
<br /> 1. Identify the status of the covered Federal action.
<br /> 2. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information
<br /> previously reported,enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report
<br /> by this reporting entity for this covered Federal action.
<br /> 3. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the
<br /> appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or sub-award recipient. Identify
<br /> the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to
<br /> subcontracts, subgrants and contract awards under grants.
<br /> 4. If the organization filing the report in Item 4 checks "Subawardee", then enter the full name, address, city, state and zip code of
<br /> the prime Federal recipient. Include Congressional District,if known.
<br /> 5. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below
<br /> agency name,if known. For example,Department of Transportation,United States Coast Guard.
<br /> 6. Enter the Federal program name or description for the covered Federal action(Item 1). If known,enter the full Catalog of Federal
<br /> Domestic Assistance(CFDA)number for grants,cooperative agreements,loans,and loan commitments.
<br /> 7. Enter the most appropriate Federal Identifying number available for the Federal action identified in Item 1 (e.g., Request for
<br /> Proposal(RFP)number, Invitation for Bid(IFB)number, grant announcement number,the contract grant, or loan award number,
<br /> the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001."
<br /> 8. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount
<br /> of the award/loan commitment for the prime entity identified in Item 4 or 5.
<br /> 9. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in Item
<br /> 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 Last Name,
<br /> First Name and Middle Initial(MI).
<br /> 10. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4)to the lobbying entity
<br /> (Item 10). Indicate whether the payment has been made(actual)or will be made(planned). Check all boxes that apply. If this is
<br /> a material change report,enter the cumulative amount of payment made or planned to be made.
<br /> 11. Check the appropriate boxes. Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature
<br /> and value of the in-kind payment.
<br /> 12. Check the appropriate boxes. Check all boxes that apply. If other,specify nature.
<br /> 13. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the
<br /> date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federal
<br /> officials. Identify the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that
<br /> were contacted.
<br /> 14. Check whether or not a SF-LLL-A Continuation Sheet(s)is attached.
<br /> 15. 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
<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,D. C.20503
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