Byrd_Anti-LobbyingCertification.pdf

The document is a Byrd Anti-Lobbying Amendment Certification form for federal contract submissions with bids or offers exceeding $100,000. The certification requires the undersigned to affirm that no federal appropriated funds have been or will be paid to influence or attempt to influence any federal agency, member of Congress, or congressional employee in connection with the awarding of federal contracts, grants, loans, or cooperative agreements.

The form mandates disclosure of any non-federal funds used or planned for lobbying activities related to the application, award, or contract. Failure to comply with the certification can result in civil penalties ranging from $10,000 to $100,000 for each violation. The document provides two checkbox options: confirming no non-federal funds have been used for lobbying, or attaching a Standard Form LLL disclosing lobbying activities. The certification must be executed and includes spaces for the type or print name, title, signature, and organization/applicant name.