**DISCLOSURE OF LOBBYING ACTIVITIES**

Complete this form to disclose lobbying activities pursuant to 31 U.S.C.
1352

(See reverse for public burden disclosure.)

+---+------------------+----+-----+-----------+---+------------------+
| 1 |                  | 2  |     |           | 3 |                  |
| \ |                  | \. |     |           | \ |                  |
| . |                  | St |     |           | . |                  |
| T |                  | at |     |           | R |                  |
| y |                  | us |     |           | e |                  |
| p |                  | of |     |           | p |                  |
| e |                  | F  |     |           | o |                  |
| o |                  | ed |     |           | r |                  |
| f |                  | er |     |           | t |                  |
| F |                  | al |     |           | T |                  |
| e |                  | A  |     |           | y |                  |
| d |                  | ct |     |           | p |                  |
| e |                  | io |     |           | e |                  |
| r |                  | n: |     |           | : |                  |
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| : |                  |    |     |           |   |                  |
+---+------------------+----+-----+-----------+---+------------------+
|   | a.  contract     |    | a   |           |   | a.  initial      |
|   |                  |    | .   |           |   |     filing       |
|   | b.  grant        |    | bid |           |   |                  |
|   |                  |    | /of |           |   | b.  material     |
|   | c.  cooperative  |    | fer |           |   |     change       |
|   |     agreement    |    | /ap |           |   |                  |
|   |                  |    | pli |           |   | For Material     |
|   | d.  loan         |    | cat |           |   | Change Only:     |
|   |                  |    | ion |           |   |                  |
|   | e.  loan         |    |     |           |   | year\            |
|   |     guarantee    |    | b.  |           |   | _\_\_\_\_\_\_qua |
|   |                  |    |   i |           |   | rter\_\_\_\_\_\_ |
|   | f.  loan         |    | nit |           |   | date of last     |
|   |     insurance    |    | ial |           |   | report\_         |
|   |                  |    |     |           |   | \_\_\_\_\_\_\_\_ |
|   |                  |    |  aw |           |   |                  |
|   |                  |    | ard |           |   |                  |
|   |                  |    |     |           |   |                  |
|   |                  |    | c.  |           |   |                  |
|   |                  |    |   p |           |   |                  |
|   |                  |    | ost |           |   |                  |
|   |                  |    | -aw |           |   |                  |
|   |                  |    | ard |           |   |                  |
+---+------------------+----+-----+-----------+---+------------------+
| 4 |                  |    | 5\. |           |   |                  |
| \ |                  |    | If  |           |   |                  |
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+---+------------------+----+-----+-----------+---+------------------+
| 6 |                  |    | 7\. |           |   |                  |
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+---+------------------+----+-----+-----------+---+------------------+
| 8 |                  |    | 9\. |           |   |                  |
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+---+------------------+----+-----+-----------+---+------------------+
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+---+------------------+----+-----+-----------+---+------------------+
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+---+------------------+----+-----+-----------+---+------------------+
| 1 |                  |    |     | 13\. Type |   |                  |
| 1 |                  |    |     | of        |   |                  |
| \ |                  |    |     | Payment   |   |                  |
| . |                  |    |     | (check    |   |                  |
| A |                  |    |     | all that  |   |                  |
| m |                  |    |     | apply):   |   |                  |
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+---+------------------+----+-----+-----------+---+------------------+
| \ |                  |    |     | a.        |   |                  |
| $ |                  |    |     | retainer  |   |                  |
| \ |                  |    |     |           |   |                  |
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| d |                  |    |     |           |   |                  |
+---+------------------+----+-----+-----------+---+------------------+
| 1 |                  |    |     | b.        |   |                  |
| 2 |                  |    |     | one-time  |   |                  |
| \ |                  |    |     | fee       |   |                  |
| . |                  |    |     |           |   |                  |
| F |                  |    |     |           |   |                  |
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| y |                  |    |     |           |   |                  |
| ) |                  |    |     |           |   |                  |
| : |                  |    |     |           |   |                  |
+---+------------------+----+-----+-----------+---+------------------+
|   |                  |    |     | c.        |   |                  |
|   |                  |    |     | c         |   |                  |
|   |                  |    |     | ommission |   |                  |
+---+------------------+----+-----+-----------+---+------------------+
|   |                  |    |     | d.        |   |                  |
| a |                  |    |     | c         |   |                  |
| . |                  |    |     | ontingent |   |                  |
| c |                  |    |     | fee       |   |                  |
| a |                  |    |     |           |   |                  |
| s |                  |    |     |           |   |                  |
| h |                  |    |     |           |   |                  |
+---+------------------+----+-----+-----------+---+------------------+
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+---+------------------+----+-----+-----------+---+------------------+
| v |                  |    |     | f. other, |   |                  |
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+---+------------------+----+-----+-----------+---+------------------+
|   |                  |    |     |           |   |                  |
+---+------------------+----+-----+-----------+---+------------------+
| 1 |                  |    |     |           |   |                  |
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+---+------------------+----+-----+-----------+---+------------------+
| 1 |                  |    |     |           |   |                  |
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+---+------------------+----+-----+-----------+---+------------------+
| 1 |                  |    |     | S         |   |                  |
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+---+------------------+----+-----+-----------+---+------------------+
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+---+------------------+----+-----+-----------+---+------------------+

INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES

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 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 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 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 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 published by the Office of Management and
Budget for additional information.

1\. Identify the type of covered Federal action for which lobbying
activity is and/or has been secured to influence the outcome of a
covered Federal action.

2\. Identify the status of the covered Federal action.

3\. Identify the appropriate classification of this report. If this is a
follow-up report caused by a material change to the information
previously reported, enter the year and quarter in which the change
occurred. Enter the date of the last previously submitted report by this
reporting entity for this covered Federal action.

4\. Enter the full name, address, city, state and zip code of the
reporting entity. Include Congressional District, if known. Check the
appropriate classification of the reporting entity that designates if it
is, or expects to be, a prime or subaward recipient. Identify the tier
of the subawardee, e.g., the first subawardee of the prime is the 1st
tier. Subawards include but are not limited to subcontracts, subgrants
and contract awards under grants.

5\. If the organization filing the report in item 4 checks "Subawardee",
then enter the full name, address, city, state and zip code of the prime
Federal recipient. Include Congressional District, if known.

6\. Enter the name of the Federal agency making the award or loan
commitment. Include at least one organizational level below agency name,
if known. For example, Department of Transportation, United States Coast
Guard.

7\. Enter the Federal program name or description for the covered
Federal action (item 1). If know, enter the full Catalog of Federal
Domestic Assistance (CFDA) number for grants, cooperative agreements,
loans, and loan commitments.

8\. Enter the most appropriate Federal identifying number available for
the Federal action identified in item 1 (e.g., Request for Proposal
(RFP) number; Invitation for Bid (IFB) number; grant announcement
number; the contract, grant, or loan award number; the
application/proposal control number assigned by the Federal agency).
Include prefixes, e.g., \"RFP-DE-90-001\".

9\. For a covered Federal action where there has been an award or loan
commitment by the Federal agency, enter the Federal amount of the
award/loan commitment for the prime entity identified in item 4 or 5.

10\. (a) Enter the full name, address, city, state and zip code of the
lobbying entity engaged by the reporting entity identified in item 4 to
influence the covered Federal action.

\(b\) Enter the full names of the individual(s) performing services, and
include full address if different from 10 (a). Enter Last Name, First
Name, and Middle Initial (MI).

11\. Enter the amount of compensation paid or reasonably expected to be
paid by the reporting entity (item 4) to the lobbying entity (item 10).
Indicate whether the payment has been made (actual) or will be made
(planned). Check all boxes that apply. If this is a material change
report, enter the cumulative amount of payment made or planned to be
made.

12\. Check the appropriate box(es). Check all boxes that apply. If
payment is made through an in-kind contribution, specify the nature and
value of the in-kind payment.

13\. Check the appropriate box(es). Check all boxes that apply. If
other, specify nature.

14\. Provide a specific and detailed description of the services that
the lobbyist has performed, or will be expected to perform, and the
date(s) of any services rendered. Include all preparatory and related
activity, not just time spent in actual contact with Federal officials.
Identify the Federal official(s) or employee(s) contacted or the
officer(s), employee(s), or Member(s) of Congress that were contacted.

15\. Check whether or not a SF-LLL-A Continuation Sheet(s) is attached.

16\. The certifying official shall sign and date the form, print his/her
name, title, and telephone number.

Public reporting burden for this collection of information is estimated
to average 30 minutes per response, including time for reviewing
instruction, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other
aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork
Reduction Project (0348-0046), Washington, D.C. 20503.