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ATTACHMENT G To APPM OMD NQ M30.Q= Ayycwlrap= MAW LOBBYING AND LITIGATION CERTIFICATE * 18/EPOW% I hereby certify that none of these funds have been used to engage in the lobbying of the Federal Government or in litigation against the United States unless authorized under existing law. Assistance AgreementNumber(s)** Chief Executive Officer Date * Complete this form pursuant to the 2001 Department of Veterans Affairs and Housing and Urban Development, and Independent Appropriations Acts, Public Law 106-277, Section 424 and 2000 Department of Veterans Affairs and Housing and Urban Development, and Independent Appropriations Acts, Public Law 106-74, Section 426 and any other subsequent Appropriation Act requirements. * *If certifying for more than one grant number and more space is needed, please list additional numbers in the space provided below: Please mail this formto your Grant Specialist DO NOT send this information to the Offence of Management do Budget. Burden Statement - The annual public reporting and "cord keeping burden for this collection of information is estimated to average 5 mimrtes er respondent Burden means the total time, effort, or financial resources appended by persons to generate, maintain, retain, or disclose or provide information to or for a Federal agency. This includes tho ffime needed to review instructions; develop, acquire, install, and utilize technology and systems for the purposes of collecting, validating, and vetifying information, processing and maintammg information, and disclosing and providing information; adjust the existing ways to comply with any previously applicable instructions and requirements; train persomel to be able to respond to a collection of information; search data sources; complete and review the collection of information; and transmit or otherwise disclose the information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control numbers for EPA's regulations are listed in 40 CFR Part 9 and 48 CFR Chapter 15 . Send comments on the Agency' s need for this information, the accuracy of the provided burden estimates, and any suggested methods for miniminng respondent burden, including through the use of automated collection techniques to the Director, Regulatory Information Division, U.S. Envirommnental Protection Agency (2137), 401 M. SL , S.W. Washington, D. C. 2MM; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, 72517th Street, NW, Washinggton, DC 20503 , Attention: Desk Officer for EPA . Include the EPA ICR number and OMB control number in any oorrespondence. EPA Fomm 5700-53 (Rev. 2-02) DEP Agreement No . GO 143 , Attachment G, Page 1 of 1