SFLLL_2_0-V2.0 (mandatory).pdf
PDF 134 KB Posted
- Opportunity number
- FR-6900-N-74
About this file
This document is a Standard Form LLL (Disclosure of Lobbying Activities) used to report federal lobbying activities. The form indicates this is an initial filing for a grant-related federal action, with the reporting entity checking the "Prime" status. Key sections include identifying the federal department/agency, federal program name, and details about lobbying registrants and individuals performing lobbying services. The form emphasizes that the disclosure is required pursuant to 31 U.S.C. 1352, with potential civil penalties of $10,000 to $100,000 for failure to file. The form is to be completed and submitted to Grants.gov, with the signature and submission date automatically recorded upon electronic submission.
SFLLL_2_0-V2.0 (mandatory).pdf
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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)
File details come from the government source that posted it. Updated .