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

i i ' INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES ‘This disclosure form shall be completed by the reporting entity, whether subawardee or prima Federal recipient, at the Initiation or receipt of @ covered Federal action, or a material change to a previous fling, pursuant to tite 31 U.S.C. section 1352. The filing of a form is required for each payment or agreementto make paymentto any lobbying entity for influencing or attempting to influence an officer or employeeof any agenoy, a Member of Congress, an officer or employee of Congress, or an employeeof a Member of Congrass in connection with a covered Federalaction. Complete all ilems that apply for both the inital filing and material change report, Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been sectired to influence the outcome of a coverad Federal action, 2. Identify the status of the covered Federal action. 2 . Identify the appropriate classification of this report. If this Is a followup repert caused by a material change te [he information previously reported, enter the year and quartarin which the change occurred. Enter the date of the last previously submitted report by this reporting ently for this covered Federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity, Include Congressional District, If known. Check the appropriate classification of the reporting entity that designates if it is, er expects to be, a prime or subaward recipient. Identify the tier of the subawardee,e.g., the first susawardee of the prime is the 1st fier. Subawards include but are not limited to subcontracts, subgrants and contract awards under granis. ca If the organization filing the report in tem 4 checks "Subawardee,"then enter the full name, address, cily, State and zip code of the prime Federal recipient. Include Congressional District, If known. ca . Enter the name of the Federal agency making the award or loan commitment. Include at least one organizationallevel below agency name, if known, For example, Department of Transportation, United States Coast Guard. N Enter the Federal program name or description for the covered Federal action (itern 1). If known, enter the full Catalog of

n, For example, Department of Transportation, United States Coast Guard. N Enter the Federal program name or description for the covered Federal action (itern 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments, 2 . Enter the most appropriate Federal identifying number avallablefor the Federal action identified in item 4 (¢.g., Request for Proposal (RFP) number; Invitation for Bid (FB) number, grant announcement number; the contract, grant, or loan award number; the epplication/proposal control number assigned by the Federal agency). include prefixes, @.9,, "RFP-DE-90-001." 9 For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 6. 40. (a) Enter the full name, address, cily, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified In item 4 to influence the covered Federal action. (b) Enter the full namas of the individual(s) performing services, and include full address if different from 10 (a), Enter Last Name, First Neme, and Middle Initial (Ml). 11. The certifying official shall sign and date the form, print his/her name, title, and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control} Number, The valid OMB control number for this information collection Is OMB No. 0348-0046, Public reporting burden for this collect|on of information is| estimated to average 10 minutes per response, including time for reviewing Instructions, searching existing data sources, gathering and maintaining the data} needed, and compleling and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of| information, including suggestions for reducing this burden, to the Office of Managementand Budget, Paperwork Reduction Project (0348-0046), Washington, | DC 20603.