A14_SFLLL_2_0-V2_0.pdf
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- Attached to
- NIH NeuroBioBank Brain and Tissue Repository
- Solicitation number
- 75N95024R00124
About this file
This document is a Lobbying Disclosure Form (SF-LLL) required for federal contract and grant opportunities. It discloses lobbying activities related to the award of a federal contract or grant. The form collects information about the reporting entity, the federal action, the lobbying registrant, and the individual performing lobbying services. This disclosure is required under 31 U.S.C. 1352 and must be filed with the applicable federal agency.
The related federal contract opportunity is for the NIH NeuroBioBank Brain and Tissue Repository, solicitation number 75N95024R00124, issued by the National Institute on Drug Abuse within the Department of Health and Human Services. The opportunity type is a solicitation, but no other details about the required products/services, response dates, award dates, or set-asides are provided.
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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: 02/28/2025
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:
CFDA 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)
File details come from the government source that posted it. Updated .