Attachment 2-SF LLL.pdf

REGISTERED LOBBYIST CONTACT DISCLOSURE

This form is to be completed by Executive Branch employees who are contacted by registered lobbyists regarding policy issues concerning the Recovery Act. This report includes a written description of each contact, the date and time of the contact, and the names of the registered lobbyist(s) and the employee(s) with whom the contact took place. The information on this form will be available to the public on the Executive Branch agency's recovery website.

To be completed by the employee contacted.

Date and time of contact:

Name of the

Employee(s) Contacted (Name and Title)

Brief description of the contact (attach separate sheet if necessary)

Name of the Employee(s) who prepared this form: Date:

Registered Lobbyist(s) Name: Title: Firm or Organization, if applicable: Client:

Required by OMB Memo M-09-16 STANDARD FORM LLL1 4/2009

DISCLOSURE OF LOBBYING ACTIVITIES

CONTINUATION SHEET

Approved by OMB 0348-0046

Reporting Entity: Page of

Authorized for Local Reproduction Standard Form - LLL-A