Project details
Project description, project location and an FAI number at the top of the page.
10-0388-9
Certification Regarding Lobbying
- Agency
- VA
- Revision
- July 2013
- Fillable fields
- 7
- Pages
- 1
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form 10-0388-9: Certification Regarding Lobbying
VA Form 10-0388-9 is the U.S. Department of Veterans Affairs Certification Regarding Lobbying. VA's form page lists it under VHA. The form says the certification is made in compliance with Section 319 of Public Law 101-121, and that submitting it is a prerequisite for making or entering into the transaction, imposed by section 1352, title 31 U.S. Code.
The signature block is for an authorized State official. The form's Paperwork Reduction Act notice says VA uses this information, along with other documents submitted by the States, to determine the feasibility of the projects for VA participation, to meet VA requirements for a grant award and to rank the projects in establishing the annual fiscal year priority list. It is collected under the authority of 38 U.S. Code Sections 8133(a) and 8135(a).
The form is one page: project details, three numbered statements about payments for influencing federal officials, a penalty paragraph and the signature block. You can fill out the PDF free in your browser on this page and download the result without an account.
What's on VA Form 10-0388-9
Statement (1): appropriated funds
No Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an agency officer or employee, a Member of Congress or congressional staff in connection with a Federal contract, grant, loan or cooperative agreement.
Statement (2): other funds
If funds other than Federal appropriated funds have been paid or will be paid for that kind of influence, the undersigned completes and submits Standard Forms-LLL in accordance with its instructions.
Statement (3): subawards
The certification language is to be included in award documents for all subawards at all tiers, including subcontracts, subgrants and contracts under grants, loans and cooperative agreements.
Penalty paragraph
The form says any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Signature and notice
Name and title of the authorized State official, signature and date in mm/dd/yyyy, then a Paperwork Reduction Act notice with OMB Number 2900-0661 and an estimated burden of 1 hour.
How to complete VA Form 10-0388-9
- 1
Enter the project details
Fill in the project description, project location and FAI number.
- 2
Read the three statements
The undersigned certifies the statements in paragraphs (1) to (3) to the best of their knowledge and belief.
- 3
Check whether Standard Forms-LLL applies
Paragraph (2) points to Standard Forms-LLL, "Disclosure Form to Report Lobbying," when funds other than Federal appropriated funds have been paid for influencing officials.
- 4
Add the official's name and sign
Enter the name and title of the authorized State official, then sign and enter the date as mm/dd/yyyy.
- 5
Include it in the grant package
The form says VA uses it with other documents submitted by the States for a grant award. It prints no mailing address.
Why fill Form 10-0388-9 on indox
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Where it goes
Submission
The form prints no mailing address or submission method. Its notice says VA uses it along with other documents submitted by the States for a grant award.
A prerequisite
The form says submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31 U.S. Code.
The 10-0388 series
VA's forms list places this form in the 10-0388 series, whose other forms cover State Home construction and acquisition grants.
Edition
The current edition is dated JUL 2013. It carries OMB Number 2900-0661 with an estimated burden of 1 hour.
Related forms
10-0388-1
Documents and Information Required for State Home Construction and Acquisition Grants Initial Application
7 fields, 2 pages
10-0388-5
Additional Documents and Information Required for State Home Construction and Acquisition Grants Application
7 fields, 2 pages
10-0388-8
Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals
6 fields, 1 page
10-0388-10
Certification of Compliance with Federal Requirements—State Home Construction Grant
6 fields, 1 page
10-0388-12
Certification Regarding Debarment, Suspension, Ineligibility, Voluntary Exclusion—Lower Tier Transactions
8 fields, 2 pages
10-0388-14
Checklist of Major Requirements for State Home Construction/Acquisition Grants
90 fields, 2 pages
Who uses VA Form 10-0388-9?
The form names who signs it and who else it reaches.
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Questions about Form 10-0388-9
Who signs VA Form 10-0388-9?
The signature block asks for the name, title and signature of the authorized State official, with the date in mm/dd/yyyy.
What law is the certification made under?
The form says it is made in compliance with Section 319 of Public Law 101-121, pursuant to the Interim Final guidance published as part VII of the December 20, 1989, Federal Register. It also cites section 1352, title 31 U.S. Code.
What is the penalty for not filing it?
The form says any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
When does Standard Forms-LLL come in?
Paragraph (2) says that if funds other than Federal appropriated funds have been paid or will be paid for influencing officials in connection with the award, the undersigned completes and submits Standard Forms-LLL, "Disclosure Form to Report Lobbying."
Does the certification reach subawards?
Yes. Paragraph (3) says its language is to be included in the award documents for all subawards at all tiers, and that all subrecipients certify and disclose accordingly.
How long does it take to complete?
The Paperwork Reduction Act notice estimates an average of 1 hour per response.