202-18 Exhibit A - Edward Byrne Memorial Justice Assistance Grant Application.pdf

DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 Approved by OMB 0348-0048 (See reverse for public burden disclosure.) 1. Type of Federal Action: [8 | a. contract b. grant ¢. 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 For Material Change Only: year quarter date of last report 4, Name and Address of Reporting Entity: Prime (2 subawardee Tier , lf known: ‘Towuship of West, Orange: . 66 Main Street, West Orange, NID7052 Congressional District, if known: 5, If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime: Congressional District, if known: 6. Federal Department/Agency: US, Department of Justioe Office of Justice Progranis Bureau of Jéstics Assistance 7. Federal Program Name/Description: Edward Byrne Memorial Justice Assistance (JAG) Grant Program CFDA Number, iFapplicable: 16.738 9. Award Amount, if known: $ 410. a. Name and Address of Lobbying Registrant (if individual, lastname. first name. MI. NIA b, Individuals Performing Services (including address if different from No. 10a) (ast name. first name. MI): NIA . 4, information requested through this form Js authorized oy tia 34 U.S.C. eaciion * 1962. This disclosure ot lobbying activities Is @ materlal ropresantalicn of fact upon which reliance was placed by the tier above when this transaction was rade of entered into. This discosure is raquied pursuant to 3 U.S.C, 1352. This information wil ba reported to the Cangrass semi-annually and will bo avallabla for public inspection. Any person wit fails 10 flo the roquirad dischosure shell ba Subject to a chvl peralty of not less that $10,000 and not more than $100,000 for ‘ach such talkie Signature: John K. Sayers... CK Tega Print Name: John K: Sayers @ ae = Title; _ Business Administrator Telephone No.: (973) 325-4050 Date; 2 Foderal Use Only: Authorized for Local Reproduction Standard Form LLL. (Rev. 7-87)