HUD-SF-LLL

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
* Street 1
Street  2
* City
State
Zip
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:
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.
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.
* Last Name
Suffix
* Signature:
Completed on submission to Grants.gov
Completed on submission to Grants.gov
*Name:
Prefix
* First Name
Middle Name
* Last Name
Suffix
Title:
Telephone No.:
Date:
  Federal Use Only: 
Authorized for Local Reproduction 
Standard Form - LLL (Rev. 7-97)
City of Chandler Housing Authority
235 S Arizona Ave
Chandler
Arizona
Office of Public and Indian Housing (PIH)
Thom
Run
Thom
Run
Kevin 
Harke