Attachment J3 SFLLL_2_0-V2.0 (1).pdf
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- Solicitation number
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About this file
This is a Standard Form LLL (SF-LLL), the Disclosure of Lobbying Activities form, which serves as a template for entities to disclose lobbying activities conducted in connection with federal funding or contracting actions pursuant to 31 U.S.C. 1352.
The form captures essential information about the federal action type (contract, grant, cooperative agreement, loan, loan guarantee, or loan insurance) and its status (bid/offer/application, initial award, or post-award), along with the report type designation (initial filing or material change). Key data elements include the reporting entity's name and address, identification of whether the entity is a prime contractor or subawardee, the prime contractor's information if applicable, the federal department or agency involved, the federal program name and description, federal action number, award amount, and congressional district. The form requires identification of the lobbying registrant and any individual performing lobbying services, including their complete names and addresses. A signatory section captures the name, title, telephone number, and date of the person certifying the disclosure. The form notes that failure to file required disclosures subjects violators to civil penalties ranging from $10,000 to $100,000 per violation, and that disclosed information will be reported to Congress semi-annually and made available for public inspection. The OMB control number is 4040-0013 with an expiration date of June 30, 2028.
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Text version
10. a. Name and Address of Lobbying Registrant:
9. Award Amount, if known:
* Street 1
* City State Zip
Street 2
* Last Name
Prefix * First Name Middle Name
Suffix
DISCLOSURE OF LOBBYING ACTIVITIES
Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 OMB Number: 4040-0013
Expiration Date: 06/30/2028
1. * Type of Federal Action:
a. contract
b. grant
c. cooperative agreement
d. loan
e. loan guarantee
f. loan insurance
2. * Status of Federal Action:
a. bid/offer/application
b. initial award
c. post-award
3. * Report Type:
a. initial filing
b. material change
4. Name and Address of Reporting Entity:
Prime SubAwardee
* Name
* Street 1 Street 2
* City State Zip
Congressional District, if known:
5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime:
6. * Federal Department/Agency: 7. * Federal Program Name/Description:
Assistance Listing Number, if applicable:
8. Federal Action Number, if known:
b. Individual Performing Services (including address if different from No. 10a)
Prefix * First Name Middle Name
* Street 1
* City State Zip
Street 2
11.
* Last Name Suffix
Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
* Signature:
Completed on submission to Grants.gov
Completed on submission to Grants.gov
*Name: Prefix * First Name Middle Name
* Last Name Suffix
Title: Telephone No.: Date:
Federal Use Only: Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97)
Patrick Smith Comment on Text this is a contract not a grant
Patrick Smith Comment on Text this is an RFP not an award
File details come from the government source that posted it. Updated .