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10. a. Name and Address of Lobbying Registrant: 9. Award Amount, if known: $ * Street 1 * City State Zip Street 2 * Last Name Prefix * First Name Middle Name Suffix DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 OMB Number: 4040-0013 Expiration Date: 02/28/2025 1. * Type of Federal Action: a. contract b. grant c. 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 4. Name and Address of Reporting Entity: Prime SubAwardee * Name Maricopa County Sheriff's Office * Street 1 550 West Jackson Street Street 2 * City Phoenix State AZ: Arizona Zip 85003 Congressional District, if known: 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: 6. * Federal Department/Agency: Office of National Drug Control Policy 7. * Federal Program Name/Description: CFDA Number, if applicable: 8. Federal Action Number, if known: b. Individual Performing Services (including address if different from No. 10a) Prefix * First Name Middle Name * Street 1 * City State Zip Street 2 11. * Last Name Suffix 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 Jack Middle Name * Last Name Sellers Suffix Title: Chairman Telephone No.: 602-506-1776 Date: Federal Use Only: Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97) HIDTA CY25 Application SF-LLL (Lobbying Disclosure) Form 1a Maricopa County ATTEST: Juanita Garza Date Clerk of the Board of Supervisors APPROVED AS TO FORM This ____ day of ____________________, 20__ By: ___________________________________ Deputy Maricopa County Attorney