Name and Title of Official Signing for Organizational Entry Telephone No. Of Signing Official Signature of Above Official Date Signed ATTACHMENT H-2 Solicitation Number: HRDT/LDP/15-001-S DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 Type of Federal Action: Status of Federal Action: Report Type: Contract Bid/offer/application Initial filing Grant Initial award Material change Cooperative Post-award For Material Change Only: Agreement Year quarter Loan Date of last report Loan guarantee Loan insurance 4. Name and Address of Reporting Entity: If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime: if known: Prime Subawardee Tier , if known: Congressional District, Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable: if known: if known: 8. Federal Action Number, 9. Award Amount, $ 10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including address if (if individual, last name, first name, MI): different from No. 10a) (last name, first name, MI): 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $ actual planned a. retainer b. one-time 12. Form of Payment (check all that apply) c. commission d. contingent fee a. cash e. deferred specify: nature b. in-kind; f. other; specify: value 14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacted, for Payment Indicated in Item 11:
Name and Title of Official Signing for Organizational Entry Telephone No. Of Signing Official Signature of Above Official Date Signed ATTACHMENT H-2 Solicitation Number: HRDT/LDP/15-001-S DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 Type of Federal Action: Contract Grant Cooperative Agreement Loan Loan guarantee Loan insurance Status of Federal Action: Bid/offer/application Initial award Post-award Report Type: Initial filing Material change For Material Change Only: Year quarter Date of last report 4. Name and Address of Reporting Entity: Prime Subawardee Tier , if known: Congressional District, if known: If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known: $ 10. a. Name and Address of Lobbying Registrant (if individual, last name, first name, MI): b. Individuals Performing Services (including address if different from No. 10a) (last name, first name, MI): 11. Amount of Payment (check all that apply) $ actual planned 13. Type of Payment (check all that apply) a. retainer b. one-time c. commission d. contingent fee e. deferred f. other; specify: 12. Form of Payment (check all that apply) a. cash b. in-kind; specify: nature value 14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacted, for Payment Indicated in Item 11:
FINAL%20LDI%20RFP.docx