5-5515 grazing permit

Form 5-5515 UNITED STATES OMB No. 1076-0157

ATTACH FORM 5-5521 F0R DEPARTMENT OF THE INTERIOR Expires 02/28/2010

ON‑AND‑OFF PERMITS BUREAU OF INDIAN AFFAIRS

GRAZING PERMIT

Contract No._________________ An execution fee shall be payable annually in advance pursuant to 25 CFR 166.500

(WRITE ALL NAMES IN FULL) ____________________________

(Range unit number or name)

____________________________________ ___________________________________ ____________________________________

(Agency) (Reservation) (Tribe)

By authority of law and under the regulations (25 CFR 166) prescribed by the Secretary of the Interior, ________________________________

(Name of permittee)

_____________________________________, is hereby granted permission to hold and graze livestock on the Trust Indian and Government

(Post‑office address)

owned lands in the foregoing range unit of the said Reservation, a schedule of which is attached and made a part of this permit, for a period beginning ___________________________, and terminating not later than _________________________________.

(Date) (Date)

CLASS OR USE FOR RENTAL, CHARGES STOCKING, ETC.	AUMs	NUMBER OF HEAD	KIND OF STOCK	GRAZING SEASON		*ANNUAL RENTAL
				From --	To --	Amount	Date Payable
Regular Fees						$
Other
Allottee Use
On-and-Off
Total

Brands.---Unless authorized by the Superintendent of the Agency in writing, only livestock bearing the brands and marks herein shown shall be grazed under authority of this permit:

CATTLE BRANDED EAR MARK HORSE BRANDS SHEEP BRANDED EAR MARK

L R Wool mark L R

Issued at the above Indian Agency this_____ day of __________________________________

Month/Year

*Payment

To: Bureau of Indian Affairs$___________________________ ______________________________________________ [SEAL]

(Superintendent)

Office of the Special Trustee$_______________________

Tribal Treasurer $_______________________________________

I accept this permit and the attached Range Control Stipulations.

Witness_________________________________________

Witness ________________________________________ ______________________________________________ [SEAL]

(Permittee)

(SEE‑REVERSE FOR ADDITIONAL TERMS AND CONDITIONS)

Payment of Rental: Bond Requirement--- In consideration of the privileges granted by this permit the permittee agrees to pay the rentals and execution fees due annually according to the provisions of this permit. An acceptable bond guaranteeing full performance of this permit may be required. Over payment of rental will be refunded.

Rental Adjustment – Grazing rental may be adjusted during the permit period and permit modified in accordance with 25 CFR 166.408.

Termination and Modification. --- It is understood and agreed that this permit is revocable in whole or in part pursuant to 25 CFR 166.300. It is also understood and agreed that any part of the area covered by this permit may be excluded from this range unit by the Superintendent in the exercise of his discretion, or by the transfer of title through sale of allotted land, or by the extinguishment of the Indian right of occupancy of the lands; and thereupon this permit shall cease and determine as to the parts of the range unit thus eliminated, the number of stock stipulated shall be reduced in conformity thereto, and the payments due hereunder shall be adjusted accordingly, provided that the termination of this permit has not been due to the fault of the permittee or to a violation of the terms of this permit by or on behalf of the permittee.

Lien Upon Livestock.--- All payments due hereunder shall constitute a prior and first lien upon all livestock grazed under this permit and other property incidental to the enjoyment of the privileges granted, except that when the permittee obtains a loan from the Farm Service Agency it is understood and agreed that the prior and first lien upon said livestock and other property under this provision in the permit shall be subordinated to the lien of all chattel mortgages now held or hereafter acquired by the Farm Service Agency from the permittee except as to the payment of the annual grazing fees due for the first operating year of the loan.

Lands Not Covered By Permit.--- It is understood and agreed by the permittee that he shall fence out all open range lands which the owners have not authorized for inclusion under this permit, or deposit with the Superintendent annually a sum equal to the annual rental which would have accrued had the lands been covered by this permit. It is further understood and agreed that the deposit shall be retained as liquidated damages if the permittee's livestock graze on such lands. Failure to comply with this requirement, in addition to the other clauses herein provided, shall be cause for termination of the permit. If the permittee's livestock do not graze on such lands the deposit will be refunded.

Assignment or Subletting. --- This permit shall not be assigned or sublet without the written consent of the parties thereto and the surety, pursuant to the regulations.

Interpretation of Permit Provisions. --- The Superintendent will make decisions relative to the interpretation of the terms of this permit and the range control stipulations which are attached hereto, and the terms of this permit cannot be varied in any detail as herein provided without the written approval of the parties thereto and the surety.

Rights‑of‑Way. --- It is understood and agreed that authority is reserved to the Superintendent to grant access to and across any of the lands covered by this permit as he deems in the interest of the Indians, including the privilege of prospecting for oil, gas, and other minerals.

Entry on Premises – BIA approving official, his/her representative, or the permittee may enter upon the premises covered by this permit at such reasonable times as may be desired for inspection or for the purpose of exercising any of the rights reserved under this permit.

Restriction.--- No Member of, or Delegate to Congress, or Resident Commissioner shall be admitted to any share or part of this permit, or to any benefit that may arise therefrom, but this provision shall not be construed to extend to this permit if made with a corporation or company for its general benefit.

Indemnity – Land user agrees to indemnify and hold the United States and the Indian landowners harmless from any loss, liability, or damages resulting from the use or occupation of the premises. Land user also agrees to indemnify the United States and the Indian landowners against all liabilities or costs relating to the use, handling, treatment, removal, storage, transportation, or disposal of hazardous materials, or the release or discharge of any hazardous materials from the premises that occur during the contract term, regardless of fault.

Provision

Filing of Permits. --- The Agency office contains public records of the United States pertaining to Trust Indian allotments and all persons are charged with notice and knowledge thereof. A copy of each permit must be filed promptly in the Agency office. Such copy shall be available at all times for public inspection. If the permittee so desires he may file or record a copy of this permit, at his own expense, in the proper county office.

SPECIAL PERMIT REQUIREMENTS AND PROVISIONS

1. While the lands covered by the permit are in trust or restricted status, all of the permittee's obligations under the permit and the obligation of his sureties are to the United States as well as to the owner of the land.

2. Nothing contained in the permit shall operate to delay or prevent a termination of Federal trust responsibilities with respect to the land by the issuance of a fee patent or otherwise during the term of the permit.

3. The permittee agrees he will not use, cause, or allow to be used any part of the permitted area for any unlawful conduct or purpose.

4. The permit authorizes the grazing of livestock only and the permittee shall not utilize the permitted area for hay cutting hunting, post or timber cutting, or any other use without written authorization from the responsible Indian or Federal authority.

Paperwork Reduction Act Statement: This information is collected to manage agriculture and grazing leases. The information is supplied by a respondent to obtain or retain a benefit, that is, a lease. It is estimated that responding to the request will take an average of 20 minutes to complete. This includes the amount of time it takes to gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Control Officer, Bureau of Indian Affairs, 1849 C Street NW, Mail Stop 4603 MIB, Washington, DC 20240. Note: comments, names and addresses of commentors are available for public review during regular business hours. If you wish us to withhold this information, you must state this prominently at the beginning of your comment. We will honor your request to the extent allowable by law. In compliance with the Paperwork Reduction Act of 1995, as amended, the collection has been reviewed by the Office of Management and Budget and assigned a number and expiration date. The number and expiration date are at the top right corner of the form. Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless there is a valid OMB clearance number.

Permittee Initial __________