SFLLL_DISCLOSURE OF LOBBYING ACTIVITIES_04-25-19.PDF

DISCLOSURE OF LOBBYING ACTIVITIES
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Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352
4040-0013
1. * Type of Federal Action: 2. * Status of Federal Action: 3.* Report Type:
a. contract II a. bid/offer/application Di<1 a. initial filing
i b. grant b. initial award II b. material change
El c. cooperative agreement El c. post-award
d. loan
e. loan guarantee
Lii f. loan insurance
4. Name and Address of Reporting Entity:
Prime El SubAwardee
• Name
Maricopa County Sheriff's Office
* Street 1 Street 2
550 West Jackson Street
• City State Zip
Phoenix AZ: Arizona 85003
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 10 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
Bill
* Last Name Suffix
Gates
Title: chairman Telephone No.: Date:
Authorized for Local Reproduction
Federal Use Only: Standard Form - LLL (Rev. 7-97)