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DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 OMB Number: 4040-0013 Expiration Date: 02/28/2022 1. * Type of Federal Action: 2. * Status of Federal Action: 3. * Report Type: a. contract a. bid/offer/application a. initial filing b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan e. loan guarantee f. loan insurance 4. Name and Address of Reporting Entity: Prime SubAwardee * Name Maricopa County Sheriff's Office * Street 1 Street 2 550 West Jackson Street * City State Zip Phoenix AZ: Arizona 85003-2412 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: Office of National Drug Control Policy CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known: $ 10. a. Name and Address of Lobbying Registrant: Prefix * First Name Middle Name * Last Name Suffix * Street 1 Street 2 * City State Zip b. Individual Performing Services (including address if different from No. 10a) Prefix * First Name Middle Name * Last Name Suffix * Street 1 Street 2 * City State Zip 11. 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: *Name: Prefix * First Name Middle Name Jack * Last Name Suffix Sellers Title: Chairman Telephone No.: 602-506-1776 Date: Authorized for Local Reproduction Federal Use Only: Standard Form - LLL (Rev. 7-97) HIDTA CY22 Application SFLLL Maricopa County ATTEST: Juanita Garza Date Clerk of the Board of Supervisors APPROVED AS TO FORM This ____ day of ____________________, 2021 By: ___________________________________ Deputy Maricopa County Attorney