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Grazing Permits, 25 CFR 166

Forms from handbook

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Agricultural and Range Management Handbook Appendix Q

FORMS

Electronic forms to be developed later will be PDF fillable. Print these forms from the available electronic files or secure appropriate copies that can be reproduced. Copies may be available with the hardcopy version of this handbook.

Forms index

SALE OF GRAZING PRIVILEGES Form 5-5513

Notification Document- provides a uniform basis for the advertisement of grazing privileges on range units for competitive bidding on Indian trust lands and Government owned lands in range units. Executed copies will be filed in the Grazing Permit Bid Files, 4505- P5F

BID FOR GRAZING PRIVILEGES Form 5‑5514

Form used to submit bids for grazing. A standard form is used so that all necessary information is provided to the deciding official. An abstract of all bids, by Range unit, will be filed in Grazing Permit Bid Files, 4505-P5F.

GRAZING PERMIT Form 5-5515

Permit form used to issue a permit to an individual, association, organization, etc. for other than a Free Use Permit, 5-5517. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

GRAZING PERMIT FOR ORGANIZED TRIBES Form 5-5516

Suggested form for grazing permit for use by organized tribes to issue permits themselves. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

FREE GRAZING PERMIT (Tribal Lands) Form 5‑5517

Suggested Form for use by a tribe to issue a Free Grazing Use Permit to a tribal member for use on tribal lands. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

RANGE CONTROL STIPULATIONS Form 5-5518

Basic contractual and other requirements in the granting of grazing permits, Permittee will sign acceptance of this form. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

CASH PENAL BOND FOR GRAZING PERMITS Form 5-5519

Form used to accept and receipt a cash performance bond and acknowledge the power of attorney for the bond and the bond will be applied to the last years installment of the grazing fee. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

PERFORMANCE BOND Form 5-5423

Form used for performance bonds for construction and/or maintenance of improvement or any item or actions stipulated to in the permit or conservation plan. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

POWER OF ATTORNEY Form 5-5520

Form used to give the Regional Director attorney- in -fact authority to collect or sell, assign, and transfer the listed negotiable bonds and obligations. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

CERTIFICATE & APPLICATION FOR ON-AND-OFF GRAZING PERMIT Form 5-5521

This allows the permittee a stocking rate credit for other range land not covered by the permit which are owned or controlled by the permittee and used as a part of his range unit. This form is attached to the Grazing Permit, 5515. The stocking rate credit calculation should be attached or noted on this form and the associated permit, 5515. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

MODIFICATION OF GRAZING PERMIT (5-5515) Form 5‑5522

Form used to make modifications to an existing permit. Corrections of administrative nature and minor corrections can be noted on the permit itself and effected parties initial changes. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

ASSIGNMENT OF GRAZING PERMIT Form 5-5523

Form used to assign a permit in effect to another person. The assignment does not necessary confer any preference of the present permittee to the assignee. Consent of surety and all the original contracting parties is required. (See page 2 of the form, which is titled CONSENT OF SURETY.) Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

APPLICATION FOR ALLOCATION OF GRAZING PRIVILEGES Form 5-5524

Form used by tribal members to apply for allocation of grazing privileges without competitive bid.

AUTHORITY TO GRANT GRAZING PRIVILEGES ON ALLOTTED LANDS Form 5-5525

Form used to obtain consent from adult owners and their minor children for the Superintendent to grant revocable grazing permits when such lands are not used by the owners for the grazing of their own livestock. Executed form will be filed in the appropriate Grazing Permit Case File, 4506-P10F.

STOCKING RATE FOR INDIAN LANDS IN RANGE UNITS Form 5-5526

Form submitted by the Superintendent to the Regional Director for purposes of setting or adjusting the stocking rate on trust and government lands. The stocking rate should be delineated down to the smallest unit of management possible, i.e. pasture. Copy is filed in the Range Unit File 4502-P3 and in the Range Survey Files, 4504-P.

STOCK COUNTING RECORD Form 5-5527

Form used to record observed livestock at a specific location at a specific time. Form is maintained in the Grazing Permit Case File, 4506-P10F

LIVESTOCK CROSSING PERMIT Form 5-5528

Form used to authorize the specified livestock to cross trust lands at the location and time specified on the permit. Copy of the completed form will be in the Range Unit File 4202-P3 and each affected Grazing Permit Case File, 4506-P10F.

REMOVABLE RANGE IMPROVEMENT RECORDS

This form is used to document range improvements that are constructed or owned

by the permittee, and can be removed at the end of the permit term, or upon approval of BIA. A copy of the completed form will be kept in the range unit file.

Form 5-5513 UNITED STATES ATTACH BID FORM 5-5514

DEPARTMENT OF THE INTERIOR

BUREAU OF INDIAN AFFAIRS

SALE OF GRAZING PRIVILEGES

____________________________ ______________________________ _______________________________

Reservation Agency Address

Sealed bids for grazing privileges under permit on range units of the above Indian reservation for a ________ year period beginning __________________, and terminating not later than _______________, will be received at the office of the

(Date) (Date)

Superintendent of the above Indian Agency until ____ p.m., (local)________ time, ___________________,and will be opened

(Date)

immediately thereafter in the presence of such bidders as may attend. No bids tendered after the closing time will be received or considered. All bids must be addressed to the Superintendent of the said Indian Agency and be plainly marked on the outside of the envelope, "Bid for Grazing Privileges." Bids received before closing time will be securely kept unopened by the Superintendent until the time‑of opening, but the Bureau of Indian Affairs shall not be responsible to any bidder for premature opening of bids or failure to consider bids not properly identified or addressed.

Grazing permits now in effect will expire _____________________ ,________ .

A schedule of range units showing approximate location and areas, maximum allowable stocking by livestock classes, grazing season, and minimum annual rentals, is attached.

Each bid must be accompanied by a cashier's check, certified check, or bank draft, drawn upon a solvent bank, or money order, payable to the order of the Bureau of Indian Affairs, for not less than 26 percent of the minimum annual rental. Personal checks will not be accepted. All deposits of unsuccessful bidders will be returned.

It is proposed to award the grazing privileges to the highest and best bidders, but the right is reserved to reject any or all bids and to adjust the boundaries or change the stocking rate of any of the range units at any time as may be deemed or the best interest of the Indians. Such adjustments and changes as may be necessary will be made at the end of the annual period of the permit whenever feasible.

The successful bidder will be given a permit to graze his livestock on all unallotted land authorized by the Indian tribe, on all Indian allotments on which proper authority has been or may be obtained, and on such Government‑owned lands which form a part of a specified range unit. Such permit will be issued pursuant and subject to the General Grazing Regulations, 25 CFR 166 and all amendments thereto, and other applicable parts of Title 25---Indians, Code of Federal Regulations. The successful bidder shall be required to fence out open range lands which the owners have not authorized for inclusion under the grazing permit, or deposit with the Superintendent annually a sum equal to the annual rental which would have accrued if the lands had been covered by the permit. This deposit shall be retained as liquidated damages if the permittee's livestock graze on such lands. If the permittee's livestock does not graze on the lands the deposit will be refunded at the end of the annual period of the permit.

Grazing rentals shall be paid annually in advance. An acceptable bond guaranteeing full performance of grazing permits may be required pursuant to 25 CFR 166.23 600. In case the bidder to whom the award is made shall fail within thirty (30) days after having been notified of the award to sign the permit and furnish a satisfactory bond, if required, and pay a sum which together with the amount of the advance deposit shall equal the first annual advance rental due under the permit, his deposit will be retained by the United States for the use and benefit of the Indians unless an extension of time to complete the permit is authorized by the Superintendent in writing. In addition to the annual rental the permittee shall be required to pay a fee for preparation on the permit as prescribed by the regulations, 25 CFR 166.22 500.

Improvements placed on the permitted land shall be considered affixed to the land unless specifically excepted there from under the permit terms. Written permission to construct and to remove improvements must be secured from the Superintendent. The permit will specify the maximum time allowed for removal of improvements so excepted. The permittee will be required by the terms of the permit to perform reasonable maintenance of all range improvements on the unit in a manner acceptable to the Superintendent or his duly authorized representative.

All grazing permits granted pursuant to 25 CFR 166 reserve to the Superintendent authority to grant access to and across any of the lands covered by the permit as he deems in the interest of the Indians, including the privilege of prospecting for oil, gas, and other minerals.

(IMPORTANT - SEE REVERSE)

Page 2 – Form 5513

Copies of the permit form, range control stipulations, and other forms and information may be obtained from the Superintendent. A map showing location of range units is available for examination at the agency office. The Bureau of Indian Affairs is not responsible to the bidder to whom the award is made in the event the range unit is not suitable to the bidder's needs. Each prospective bidder is urged to obtain full and prior information with respect to any range unit on which he plans to submit a bid.

Bids which do not accord to the terms of this advertisement will be rejected. The right of the Superintendent to waive

technical defects in the advertisement and bids received is, however, reserved.

The foregoing is modified by and to the extent of the following conditions and stipulations, or by the attachments which are made a part of this advertisement:

___________________________________ _______________________________________

(Date) (Superintendent)

Form 5‑5514 UNITED STATES OMB No. 1076-0157

May 1970 DEPARTMENT OF THE INTERIOR Expires: 12/31/2006

BUREAU OF INDIAN AFFAIRS

BID FOR GRAZING PRIVILEGES

To the Superintendent,

_______________________Indian Agency __________________________________ , _______________________________________

Sir:

In response to the notice of sale of grazing privileges under permit for a _______ year period beginning _________________________

(Date)

and terminating not later than ____________________________, on the ________________________ Indian Reservation, bids to be opened at

(Date)

the office of the Superintendent at _____ o'clock ____ m. on the ______ day of ,______________ , I (or we) hereby submit the following bid:

Name or Number of Range Unit

Number of Head

Kind of Livestock

Grazing Season

Annual Rental

From --

To --

I (or we) remit herewith_________________________________(indicate whether cashier's or certified check. bank draft, or money order) in the amount of $____________________ , drawn in favor of the Bureau of Indian Affairs as required by the notice of sale, and agree that if my (or our) bid is accepted, and I (or we) shall fail to fulfill my (or our) agreement in accordance with the regulations governing the sale, then the amount of this deposit shall be retained as liquidated damages for the use and benefit of the Indians concerned. It is understood that if my (or our) bid is rejected the deposit will be returned.

Respectfully,

_______________________________________ _____________________________________________________

(Date)

________________________________________ ______________________________________________________

(Address)

______________________________________________________

INSTRUCTIONS

Enclose this bid in a sealed envelope addressed to the Superintendent of the above Indian agency. Do not submit in duplicate. Mark plainly, "BID FOR GRAZING PRIVILEGES."

A separate bid must be submitted for each range unit desired.

If the bid is made by individuals, acting neither as a firm nor as a corporation, each must sign.

If the bid is made by a copartnership, the signature must consist of the name of the firm followed by the signature of each of the members thereof.

If the bid is made by a corporation, the signature must consist of the name of the corporation, followed by the name of the proper officer or officers as required by the laws of the corporation, accompanied by evidence of authority of such officer or officers to bind the corporation.

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 Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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.

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

ATTACH FORM 5-5521 F0R DEPARTMENT OF THE INTERIOR Expires 12/31/2006

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 166.26.500

(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.

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)

Tribal Treasurer $______________________________

I accept this permit and the attached 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 .

Termination and Modification.--- It is understood and agreed that this permit is revocable in whole or in part pursuant to 25 CFR 166.18 300. 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 causes 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.

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.

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.

Form 5-5516 UNITED STATES OMB Form 1076-0157

DEPARTMENT OF THE INTERIOR Expires 12/31/2006

BUREAU OF INDIAN AFFAIRS

GRAZING PERMIT FOR ORGANIZED TRIBES

(WRITE ALL NAMES IN FULL)

The __________________________ Tribe of the _____________________________ Indian Reservation and______________________ Agency,

(Name of organized tribe)

organized under a constitution and bylaws, pursuant to section 16 of the Act of June 18, 1934 (48 Stat. 984), and incorporated pursuant to section 17 of the said act (Delete reference to incorporation where charter not issued) by authority of law and under the regulations (25 CFR 166) prescribed by

the Secretary of the Interior, hereby grants permission to____________________________________ of ______________

(Name of Permittee)

______________________________________________, to hold and graze livestock on the tribal land of range unit __________________

(Post -office address) (Number or Name)

of said Reservation, a schedule of said lands is attached hereto and made a Part of this permit, for a period beginning,_____________ , and

(Date)

terminating not later than, _______________, covering livestock in the number, kind, and the grazing season as shown in the following

(Date)

schedule subject to the payment of all fees and full compliance with the attached range control stipulations which are made a part of this permit:

NUMBER OF HEAD

KIND OF STOCK

GRAZING SEASON

ANNUAL

RENTAL

DATE AND PLACE PAYABLE

From

This permit is issued with the understanding that a total of______________ head of ________________ will be grazed on this unit, the grazing capacity of privately owned or leased lands in the unit being _______________ head of , the right to the use of which is recorded with the Superintendent of the Reservation and a schedule of which is attached hereto and made a part of this permit.

This permit shall be of no force or effect until signed and sealed by the authorized tribal officers and approved by the Superintendent of the Indian Agency.

Issued at the ______________________________________ this ________ day of________________________

(Agency or Tribal Office) (Month / Year)

___________________________________________________

(Name of tribal organization)

By_________________________________________________

___________________________________________________

(Title)

I accept this Permit and the attached range control stipulations.

Witness_____________________________________

Witness_____________________________________ Permittee_________________________________________________

Approved:___________________________________

(Date)

___________________________________________ (SEE REVERSE FOR ADDITIONAL TERMS)

(Superintendent)

Page 2 - Grazing Permit for Organized Tribes OMB No. 1076-0157

Unless authorized by the officers issuing and approving this permit in writing only livestock bearing the brands and marks herein shown shall be grazed under authority of this permit:

Draw Brands And Where Located On Animal

In consideration of the above privileges the permittee agrees to pay the said tribe the sum of money found to be due from the permittee according to the provisions of this permit and the permittee further agrees to pay the grazing fees annually in advance. An acceptable bond as described in the regulations (25 CFR 166. 600) may be required to guarantee full performance of this permit.

It is understood and agreed by the permittee that this permit is terminable and revocable in whole or in part pursuant to the regulations (25 CFR 166.230). 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, 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 had 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.

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. The agency office contains public records of the United States pertaining to Indian tribal lands 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.

This permit shall not be assigned, sublet, or transferred without the written consent of the parties thereto, and the surety if any, pursuant to the regulations (25 CFR 166.229).

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 except as herein provided without the written approval of the parties thereto and the surety.

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.

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.

Form 5‑5517 UNITED STATES OMB No. 1076-0157

DEPARTMENT OF THE INTERIOR Expires: 12/31/2006

BUREAU OF INDIAN AFFAIRS

FREE GRAZING PERMIT

(Tribal Lands)

_______________________________ __________________________________ ____________________________________

Tribe Reservation Indian Agency

By authority of law and under the regulations prescribed by the Secretary of the Interior (25 CFR 166) and under the authority of the Constitution and Bylaws of the ________________________ Tribe, the following enrolled member, Mr. (Mrs.) ________________________ is hereby granted free grazing privileges on Range Unit___________ for his (her) livestock and the livestock of his (her) immediate family. These free grazing privileges apply only to the livestock listed in the following schedule and are subject to full compliance with federal and tribal regulations and with the attached stipulations which are made a part of this permit.

Livestock

Grazing Season

Permit Period

Draw Brands

And Location

Number

Kind

From

This permit shall not be assigned, sublet or transferred. It is understood and agreed by the permittee that this permit is terminable and revocable in whole or in part pursuant to the regulations (25 CFR 166 ) or upon the ______________________ Tribe's withdrawal of its consent to these free grazing privileges. The Superintendent shall make decisions relative to the interpretation of the terms of this permit and the Range Control Stipulations.

issued at the said Indian agency on this _________ day of ________________________________.

(Month, Year)

_________________________________________

(Name of tribal organization)

By___________________________________________

__________________________________________

I accept this permit and the attached range control stipulations. (Title)

Witness _____________________________________________

Witness _____________________________________________ ___________________________________________

(Permittee)

Approval Date: ________________________________________

___________________________________________

Superintendent

Form 5-5518 UNITED STATES

DEPARTMENT OF THE INTER10R

BUREAU OF INDIAN AFFAIRS

RANGE CONTROL STIPULATIONS

1. APPLICABILITY OF STIPULATIONS

The following range control stipulations are hereby prescribed for use in all grazing permits except as special provisions shall be made by the Assistant Secretary ~~Commissioner~~ of Indian Affairs.

2. EXCESS OR DEFICIT OF THE NUMBER OF STOCK SPECIFIED

Unless the number of livestock specified in the permit is reduced by the Assistant Secretary ~~Commissioner~~ of Indian Affairs, the permittee will not be allowed credit or rebate in case the full number is not grazed on the range unit. However, if the number of livestock authorized is exceeded, the permittee shall be liable to pay as liquidated damages, in addition to the regular fees for the full grazing season as provided in the permit, a sum equal to 60 percent thereof for such excess livestock and such livestock shall be promptly removed from the unit.

3. CROSSING PERMITS

The driving of livestock by a permittee across restricted Indian land not covered by his grazing permit must be authorized by a crossing permit approved by the Superintendent. The right is hereby reserved for the Superintendent to issue crossing permits over any range unit and to supervise the movement of livestock so authorized.

4. QUARANTINE REGULATIONS

All stock covered by grazing and/or crossing permits are subject to the quarantine laws and regulations now in force or hereafter to be promulgated by the United States, the State in which the reservation is situated, and by the tribal governing body.

5. ENTERING THE RANGE

The earliest date upon which stock will be permitted to enter the range will be the date shown in the permit. Notice must be given to the Superintendent prior to entering the reservation. On reservations where permanent driveways have been established all livestock will be required to enter or leave the reservation on the particular driveway designated by the Superintendent. Except where livestock are transported over or trailed over established rights‑of‑way, the route to be followed will be designated by the Superintendent.

6. COUNTING OF LIVESTOCK

All livestock authorized to graze upon or trail over restricted Indian land must be counted by the Superintendent or his representative. Arrangements should be made for counting all livestock before it enters the reservation. Permittees are required to notify the Superintendent a sufficient length of time in advance to permit him to have a representative present when stock are counted on or off the reservation. The right is reserved by the Bureau of Indian Affairs to have a representative present at each roundup to check the nurnber of stocks and in the event that the permittee shall fail or refuse to round up his stock at proper times and in a satisfactory manner for the purpose of allowing a count of the stock, the Superintendent shall have the right to round up and count said stock at the expense of the permittee.

7. BRANDING OF STOCK

All livestock authorized to graze upon or trail over restricted Indian land must be marked with a brand or mark issued and recorded by an appropriate state agency and filed with the Superintendent.

8. AFFIDAVIT OF PERMITTEE

The permittee may be required by the Superintendent to execute an affidavit showing the number of livestock by class and kind grazed under the permit.

9. CONDUCT IN CASE OF FIRE

Whenever a permittee discovers an unauthorized and uncontrolled fire burning, he should put it out if he can. If it cannot be put out or placed under temporary control, it should be reported to the nearest forest or range officer as soon as possible. In case of fire, all permittees shall place themselves, their employees, and their fire suppression equipment at the service of the forest or range officer in charge for such work in connection with the fire as the officer may request. The unauthorized setting of a fire or carelessness in connection with an authorized fire may result in criminal prosecution.

10. MOVEMENT OF LIVESTOCK

The Superintendent reserves the right to direct the movement of livestock whenever he deems it necessary for the proper protection and utilization of the range. The following acts are prohibited:

(a) The grazing upon or driving across any restricted Indian lands of any livestock without an approved grazing or crossing permit, except such Indian livestock may be exempted from permit.

(b) Allowing livestock not exempt from permit to drift and graze on restricted Indian lands without an approved permit.

( c ) The grazing of livestock upon restricted Indian lands within an area closed to grazing for that class of livestock.

(d) The grazing of livestock by a permittee upon an area of restricted Indian lands withdrawn from use for grazing purposes to protect it from damage by reason of the improper handling of the livestock, after the receipt of notice from the Superintendent of such withdrawal, or refusal to remove livestock upon instructions from the Superintendent when an injury is being done to the Indian lands by reason of improper handling of livestock.

11. DAMAGE TO INDIAN LAND AND PROPERTY

The permittee will be liable and will be required to repair or make reimbursement for any damage that may be done to the premises, livestock, or property of Indians through the acts of the permittee, his employees or livestock.

12. DISPOSITION OF CARCASSES

The permittee will promptly bury or burn the carcasses of all animals which die upon lands covered by his grazing permit.

13. SALTING OF STOCK

When required by the Superintendent, all livestock grazed under permit must be salted regularly at such places and in such manner as may be designated.

(e) Using dogs as little as possible after the sheep are properly trained and keeping dogs principally to protect the flock from predatory animals.

(f) Ewes with lambs will invariably graze around the bed ground before leaving. For this reason ewes and lambs should never be camped twice in the same place if avoidable.

14. PROTECTION OF F1SH AND WILDL1FE

The Permittee must comply with the Federal State, and Tribal fish, game, and wildlife protection laws and regulations which apply to the reservation.

15. RANGE IMPROVEMENTS

It is the policy of the Bureau to encourage the construction of improvements necessary for the proper management of livestock and the utilization of the range. However, the cost of such improvements will be borne by the permittee unless otherwise provided for in the permit. The permittee shall perform reasonable maintenance of all range improvements on the unit in a manner acceptable to the Superintendent or his duly authorized representative. Improvements for proper management of livestock and range, constructed on lands covered by permit, shall be considered affixed to the land unless specifically excepted therefrom by the terms of the permit and may not be removed without the consent of the Superintendent.

16. CONDITION OF CAMPS

Facilities used for livestock management camps must be kept in a clean and sanitary condition. All rubbish, tin cans, and etc., must be properly ~~burned or buried~~ removed during occupancy and upon leaving.

17. INTERPRETATION OF STIPULATIONS

The final interpretation of these stipulations shall rest with the Secretary of the Interior.

I hereby have reviewed and shall agree to above range control stipulations noted above

_________________________________________________ ___________________

Permittee Date

Form 5-5519 UNITED STATES OMB # 1076-0157

DEPARTMENT OF THE INTERIOR Expires: 12/31/2006

BUREAU OF INDIAN AFFAIRS

CASH PENAL BOND FOR GRAZING PERMITS

KNOW ALL MEN BY THESE PRESENTS, That I (or We), herein referred to as the permittee, herewith deposit with the

Superintendent of the ________________________ Indian Agency the sum of $ _______________ to be held as a cash penal bond to guarantee full performance of the terms of a grazing permit accepted by the permittee on Range Unit ______________of the

_________________________ Indian Reservation for a period beginning ____________________________ and terminating not

(Date)

later than __________________________________.

(Date)

It is understood that this amount will be credited on the last installment of the grazing fees due under the terms of the said permit, provided that the terms thereof have been faithfully carried out by the permittee. The permittee hereby constitutes and appoints the Superintendent and his successors in office or his agent as his (or their) attorney‑in‑fact and agrees that in case of any default in the performance of any of the conditions or stipulations of the permit, the said attorney‑in‑fact shall have full power to apply the deposit in the satisfaction of any damages, demands, or deficiency arising by reason of such default as he may deem best and the permittee hereby for himself, heirs, executors, administrators, successors, and assigns, ratify and confirm whatever said attorney‑in‑fact shall do by virtue of these presents.

IN WITNESS WHEREOF, the permittee hereunto sets his (or their) hand and seal this _____ day of ___________________

(Month / Year)

WITNESSES:

______________________________________________

______________________________________________ __________________________________________________[SEAL]

(Post-office Address) Permittee.

______________________________________________ ________________________________________________________

(Post‑office address)

______________________________________________ __________________________________________________[SEAL]

(Post-office Address) Permittee

______________________________________________ ________________________________________________________

(Post‑office address)

______________________________________________

(Post-office Address)

APPROVED:

_______________________________________ ______________________________________________________

Superintendent.

Form 5-5423 UNITED STATES OMB No. 1076-0157

DEPARTMENT OF THE INTERIOR Expires: 12/31/2006

BUREAU OF INDIAN AFFAIRS

PERFORMANCE BOND

Date Bond Executed

Principal

Surety

Penal Sum of Bond (express in words and figures)

_____________________

Penal Sum Total _ _ _ _ _ _ _ _ $

Lease or Permit No.

Date of Lease or Permit

KNOW ALL MEN BY THESE PRESENTS, That we, the PRINCIPAL and SURETY above named, are held and firmly bound unto the United States of America, hereinafter called the Government, and _____________________________ (lessor or permittee). in the penal sum of the amount stated above, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firm1y by these presents, provided, however, that the liability of the Surety to either one or both of the obliges shall not exceed in the aggregate the penal sum of the bond.

THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the principal entered into a certain agreement, numbered and dated as shown above and hereto attached; and whereas the principal and surety agree that the neglect or forbearance of the lessor or permittee in enforcing against the lessee or permittee the payment of rentals or the performance of any other covenant or condition of the agreement, shall not in any way release the principal and surety, or either of them, from any liability under this bond; and whereas the principal and surety agree that in the event of any

default under such lease, the lessor or permittee may prosecute any claim, suit, action, or other proceeding against either the principal or surety without the necessity of joining the other.

NOW THEREFORE, if the principal shall well and truly perform and fulfill all the undertakings, covenants, terms, and conditions of said agreement during the original term of said agreement and any duly authorized extensions thereof, with or without notice to the surety, and during the life of any guaranty required under the agreement, and shall also well and truly perform and fulfill all the undertakings, covenants, terms, and conditions of any and all duly authorized modifications said agreement that may hereafter be made, notice of which modifications to the surety being hereby waived, then, this obligation to be void; otherwise to remain in full force and virtue.

IT IS FURTHER UNDERSTOOD AND AGREED between all parties hereto, That, if the Surety shall so elect, this bond may be cancelled by giving at least forty-five (45) days advance notice in writing to both the Principal and the Superintendent or other officer in charge of the Indian Agency or field office concerned, and this bond shall be deemed cancelled as of the date specified on such notice, the said Surety remaining liable for all acts covered by this bond which may have been committed by the Principal up to said date under the terms, conditions, and provisions of this bond.

Page 2 of form 5-5523

IN WITNESS WHEREOF, the above‑bounden parties have executed this instrument under their several seals on the date indicated above, the name and corporate seal of each corporate party being hereto affixed, and these presents duly signed by its undersigned representative, pursuant to authority of its governing body.

IN PRESENCE OF:

WITNESS INDIVIDUAL PRINCIPAL

1. ________________________________________________ as to ______________________________________________________ (SEAL)

2. ________________________________________________ as to ______________________________________________________ (SEAL)

3. ________________________________________________ as to ______________________________________________________ (SEAL)

4. ________________________________________________ as to ______________________________________________________ (SEAL)

WITNESS INDIVIDUAL SURETY

1. ________________________________________________ as to ______________________________________________________ (SEAL)

2. ________________________________________________ as to ______________________________________________________ (SEAL)

Attest:

_____________________________________________________

Attest:

_____________________________________________________

Corporate Principal

________________________________________________________

Business Address

___________________________________________

Title

AFFIX CORPORATE SEAL

____________________________________________

Corporate Surety

_______________________________________________________

Business Address

___________________________________________

Title

AFFIX CORPORATE SEAL

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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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 it 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.

Form 5-5520 UNITED STATES OMB No. 1076-0157

DEPARTMENT OF THE INTERIOR Expires: 12/31/2006

BUREAU OF INDIAN AFFAIRS

POWER OF ATTORNEY

Pledging United States Bonds or Notes as Security for Grazing Permits

KNOW ALL MEN BY THESE PRESENTS, That _________, ______________________________________________

(I or We)

of.__________________________, State of _____________________________________, partners doing

business under the firm name of _______________________________________ (cancel reference to partners if not applicable) a corporation organized and existing under the laws of the State of _______________________ , having an office and principal place of business at __________________________________ , State of _____________________ , in pursuance of a resolution of the Board of Directors of said corporation, passed on the _________ day of ____________________ a duly certified copy of which resolution is attached hereto,

(month / year)

(cancel reference to constitute and corporation if not applicable) hereby appoint the Area Director, Bureau Of Indian Affairs and his successors in office, as attorney‑in‑fact to collect or to sell, assign, and transfer certain negotiable United States bonds, or other negotiable United States obligations described as follows:

TITLE AND SERIES SERIAL NUMBER AMOUNT

___________________________________ ___________________________________ __________________________________

such obligations having been deposited pursuant to authority conferred by Section 1126 of the Revenue Act of 1925, as amended, and subject to the provisions thereof and of Treasury Department Circular No. 154, dated February 6, 1935, as security for the faithful performance of any and all conditions or stipulations of a grazing permit accepted by the undersigned on range unit _____________ of the _________________________ Indian

(number or name) (Name)

Reservation for a period beginning ____________________________and terminating not later than

(Date)

_____________________________ which is made a part thereof, and the undersigned agrees that in case of any (Date)

default in the performance of any of the conditions or stipulations of the grazing permit, the said attorney‑in‑fact shall have full power to collect said bonds, notes or any part thereof, or to sell, assign, and transfer said securities or any part thereof, without notice, at public or private sale, free from any equity of redemption and without appraisement or valuation, notice and right to redeem being waived, and to apply the proceeds of such sale or collections, in whole or in part, to the satisfaction of any damages, demands, or deficiency arising by reason of such default as said attorney‑in‑fact may deem best.

Page 2 – Form 5520

And ________ hereby for ___________ _____, _______________ heirs, executors, administrators,

(I or We) (My or Our)

successors and assigns, ratify and confirm whatever said attorney-in-fact shall do by virtue of these presents.

In Witness Whereof _______have hereunto set ________ hand this day of _________________________

(I or We) (My or Our) (Date)

WITNESSES:

__________________________________________

__________________________________________ _______________________________ (SEAL)

(P.O. Address) (Permittee)

__________________________________________ ______________________________________

(P.O. Address)

__________________________________________

(P.O. Address)

___________________________________________

___________________________________________ _______________________________ (SEAL)

(P.O. Address) (Permittee)

__________________________________________ _______________________________________

(P.O. Address)

___________________________________________

(P.O. address)

Approved:

__________________________________________

(Superintendent)

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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearanace Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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 it 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.

Form 5-5521 UNITED STATES OMB No. 1076-0157

DEPARTMENT OF THE INTERIOR Expires: 12/31/2006

BUREAU OF INDIAN AFFAIRS

CERTIFICATE AND APPLICATION FOR ON-AND-OFF GRAZING PERMIT

I (or WE), Permittee of Range Unit No. ____________ on the _________________________ reservation for the period beginning ________________, and ending ________________ DO HEREBY CERTIFY that the

(Date) (Date)

following described lands, which are within or adjoining the range unit, are legally owned, or controlled by other legal tenure, by the undersigned and are to be grazed in conjunction with the Indian Lands covered by the Grazing Permit on the said unit. Application is hereby made for an On‑and‑Off Grazing Permit pursuant to 25 CFR 166.308.

Legal Description of Lands: (Use reverse hereof if necessary)

Non‑Indian Lands:

Federal and State Lands

Other Indian Lands

Acres:

Non‑Indian: (Total)____________ ; Owned ________; Leased __________; Lease Expires__________

Federal and State : _________________________; Lease Expires ______________________________

Other Indian:______________________________; Lease Expires _______________________________________

IT IS UNDERST00D AND AGREED that the Superintendent shall establish the maximum allowable stocking of all lands to be grazed under the on‑and‑off permit and that approval of this application is made subject to the terms and conditions of the permit and applicable regulations.

__________________________________________________ __________________________________________________

(Date) (Permittee)

APPROVED:

SUPERINTENDENT:

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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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.

Form 5-5522 UNITED STATES OMB No. 1076-0157

DEPARTMENT OF THE INTERIOR Expires: 12/31/2006

BUREAU OF INDIAN AFFAIRS Modification No. __

MODIFICATION OF GRAZING PERMIT (5‑5515)

Range Unit No.____________________________________ _____Agency

Contract No. ______________________________________ ______________________________________________Reservation

Permittee_________________________________________ Date of permit ___________________________________________

BY AUTHORITY OF LAW and under the regulations (25 CFR 166), the above cited grazing permit, as previously modified by Modifications Numbers_______________________, is hereby modified to include or exclude the lands on which fees are paid, or those under the on‑and‑off clause, described in detail on the attached schedule, which is made a part hereof; and to increase or decrease the number of livestock in accordance with the authorized stocking rate of the lands, and to change the terms of the permit as indicated below:

Area of tribal land From ____________ to _________________ acres

Area of allotted land (fees paid) From.____________ to _________________ acres

Area of allottee use From ____________ to _________________ acres

Area of Government‑owned land From.____________ to _________________ acres

TOTAL From.____________ to _________________ acres

Area of owned land From.____________ to _________________ acres

Area of leased land From.____________ to _________________.acres

TOTAL ON-AND-OFF From ____________ to _________________ acres

Number stock under permit (Exclusive of On‑ From ____________ to _________________ head

and‑Off) (C.H.S.)

Number stock under allottee use From ____________ to _________________ head

Number stock under On‑and-off From ____________ to _________________ head

TOTAL NUMBER STOCK From ____________ to _________________ head

Annual grazing rental From $___________ to $_______________ .

Cash bond From $___________ to $ _______________.

Administrative fee From $___________ to $ _______________.

THIS MODIFICATION becomes effective ________________________, and does not change any of the terms, conditions, or stipulations of the permit, except as specifically set forth herein.

IN WITNESS WHEREOF the said permittee has hereunto set his hand and seal this_____ day of ______________________

(Month, year)

WITNESSES:

_________________________________________ __________________________________________

(Permittee)

_____________________________________________________

(See reverse for Consent of Surety)

CONSENT OF SURETY

(Delete if Not Applicable)

The ________________________ of _____________________________________ surety in the above‑described grazing permit hereby agrees to this modification and its continuing liability under said bond to the same extent as though no modification of the original permit had been made, provided that the aggregate liability of the said surety, under this bond, shall not exceed the sum of $__________________________

IN WITNESS WHEREOF, we hereunto set our hands and seals this ___ day of ____________________

Attest:

______________________________________________________.

(Corporate principal signature)

_______________________________________________________

Secretary

CORPORATE SEAL

OF SURETY BY ________________________________________________________

ATTEST: _________________________________________________________

(Corporate surety signature)

_______________________________________________________

Secretary

APPROVED: BY______________________________________________________

________________________________________________________

Superintendent

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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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.

Form 5-5523 UNITED STATES OMB No. 1076-0157

DEPARTMENT OF THE INTERIOR Expires: 12/31/2006

BUREAU OF INDIAN AFFAIRS

Execution fee: $______________

ASSIGNMENT OF GRAZING PERMIT ~~(5‑5515)~~

Range Unit No. _____________________________________ __________________________________________________Agency

Contract No. _______________________________________ __________________________________________________ Reservation

Permittee. ______________________________________ Date of Permit ____________________________________________

Permit Period ____________________________________ Annual Grazing Fees $ _____________________________________

For and in consideration of one dollar ($1.00) the receipt of which is hereby acknowledged, the said Permittee of the above‑described grazing permit, including all modifications thereto, hereby bargains, sells, transfers, sets over, and assigns all his right, title and interest in and to said grazing permit, subject to the approval of the Secretary of the Interior or his duly authorized representatives, to ______________________________________, effective as of ______________________________________

(Month / Year)

IN WITNESS WHEREOF the said Permittee of the foregoing grazing permit has hereunto set his hand and seal this ________ day of _____________________________

(Month / Year)

WITNESSES:

_________________________________________________ ___________________________________________________ [SEAL]

Assignor (Permittee)

_________________________________________________

ACCEPTANCE BY ASSIGNEE

The Assignee in the above and foregoing assignment, made subject to the approval of the Secretary of the Interior or his duly authorized representatives hereby accepts such assignment and agrees to fulfill all the obligations, conditions, stipulations and requirements of said permit, and the regulations (25 CFR 166), and as may hereafter be amended, and hereby agrees to furnish proper bond guaranteeing faithful compliance with said permit thus assigned, firmly binding himself, his heirs, executors, administrators, successors or assignees to full compliance therewith. (Delete bond reference if not applicable)

Unless authorized by the officers issuing and approving this permit 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

R L R L R L Wool Brand R L

WITNESSES:

________________________________________________ _______________________________________________[SEAL]

(Assignee)

________________________________________________

(See reverse for Consent of Surety)

CONSENT OF SURETY

(Delete if Not Applicable)

The __________________________________ of _________________________________________

surety in the above‑described grazing permit hereby agrees to this assignment and its continuing liability under said bond to the same extent as though no assignment of the original permit had been made.

IN WITNESS WHEREOF, we hereunto set our hands and seals this _______ day of _________________________________.

(Month / Year)

ATTEST:

_________________________________________________

(Corporate principal signature)

_________________________________________________

(Secretary)

[ CORPORATE SEAL OF SURETY ]

BY____________________________________________

_______________________________________________

(Corporate surety signature)

ATTEST:

_________________________________________________

(Secretary)

BY______________________________________________

APPROVED:

_______________________________________________________

(Superintendent)

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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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 it 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.

Form 5-5524 OMB No. 1076-0157

Expires 12/31/2006

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF INDIAN AFFAIRS

APPLICATION FOR ALLOCATION OF GRAZING PRIVILEGES

________________________________ RESERVATION _____________________________AGENCY

I (We) the undersigned enrolled member(s) of the _______________ Indian Tribe hereby apply for an allocation of grazing privileges without competitive bidding as authorized by 25 CFR 166.13. Allocated grazing privileges are requested on the following lands:

Range Unit (s) or Areas Desired: Proposed Grazing Season:

(If year‑long, insert the word year‑long instead of dates.)

__________________________________________________________ From __________________ To ___________________

I (We) certify that the number of livestock over 6 months of age owned by me (us) and to be grazed under my (our) exclusive control and supervision are as follows:

Number of Kind of Brand and Recorded Owner If Mortgaged, Name of

Livestock Livestock Location of Brand Holder of Mortgage

__________ __________ _____________ ___________________________ _____________________________________

I (We) apply for total allocated privileges for the following Number of Kind of

number and kind of livestock: Livestock Livestock

1. Owned and listed above _____________ ______________

2. In addition to those listed above _____________ ______________

Total applied for _______________ X X X X X

If this application requests allocated grazing privileges for more livestock than the applicant owns, state briefly the plans made to acquire the additional livestock, including financial arrangements for purchase.

Paperwork Reduction Act: 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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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.

(Complete the reverse side)

Page 2 of Application for Allocation of Grazing Privileges

If the applicant intends to graze any livestock owned by another person, list the number, kind, and ownership of such livestock:

Number of Kind of Brand and Tribal

Livestock Livestock Location Name and Address of Owner Member?

______________ ________________ __________ ____________________________________ Yes ____ No ____

Total X X X X X X X X X X X X X X X X X X X X X X X X

List here the description and acreage of any land owned or controlled by you that is available for the grazing or pasturing of your livestock. State how many livestock the land will support and for .how long. (Attach additional sheet if needed.)

Do you now allow or intend to allow anyone else to graze or pasture their livestock on any of the land you exclusively own or control (not shared with others) rather than graze your own livestock on it?

Yes _____ No _____ If yes, state how many livestock: ________________________

I (We) agree to abide by Title 25, Code of Federal Regulations, Part 166, and all Tribal grazing regulations and, if a grazing permit is issued, to comply fully with its terms.

WITNESS: Date:________________________________

______________________________________________ __________________________________________________________

Applicant

______________________________________________ ____________________________________________________________

Applicant

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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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.

Form 5-5525 UNITED STATES DEPARTMENT OF THE INTERIOR OMB No. 1076-0157

BUREAU OF INDIAN AFFAIRS Expires: 12/31/2006

AUTHORITY TO GRANT GRAZING PRIVILEGES ON ALLOTTED LANDS

AGENCY

RESERVATION

IDENTIFICATION NO.

NAME OF ALLOTTEE, GUARDIAN, OR HEIR

I hereby authorize the Superintendent of the said Indian Agency to accept this authority and to enter into agreements with prospective permittees, on approved forms, for the grazing of livestock upon the following lands at not less than the following rates per cow‑month based upon the estimated grazing capacities of the land.

ALLOTMENT

DESCRIPTION OF LAND

SEC.

TWP.

RGE.

INTEREST

RATE

And I do hereby agree to grant any permittee reasonable right‑of‑way over the above allotments, provided I shall receive reasonable compensation, including payment for any damage done or incurred through such right‑of‑way. The Assistant Secretary of Indian Affairs or his representative shall definitely determine what shall be considered reasonable damages. And provided, further, for and in consideration of the management, advertising and permitting of the lands by the Superintendent for grazing purposes in a manner favorable to the undersigned and for my benefit, I further agree that this instrument cannot be revoked except by giving notice in writing to the Superintendent not less than seven months prior to the termination of any grazing permit then in existence, and provided further that this notification in writing shall not terminate the grazing permit in existence; and, provided that this instrument and any modification thereof shall not be effective until a copy is filed in the said agency office.

I further agree that the proceeds arising from the permits on the above lands shall be paid to the Superintendent of the said Indian Agency and deposited in accordance with the regulations of the Department of the Interior.

I further agree that all permits issued under this authorization shall be approved in accordance with the General Grazing Regulations 25 CFR 166, approved by the Secretary of the Interior.

Place ____________________________________ Date _____________________ State ____________________________

Witness:___________________________________ ______________________________________________

(Signature of allottee, guardian, or heir)

__________________________________

Paperwork Reduction Act: 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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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.

OMB No. 1076-0157

INSTRUCTIONS FOR FORM 5-5526 Expires: 12/31/2006

The maximum stocking rate prescribed by the approval hereof shall not be increased without the prior approval of the Regional Director upon a showing that an increase may be made without risking range deterioration. Such a showing must be in the form of adequate utilization checks or range condition studies by range units which shall be made a matter of record. Decreases in maximum allowable stocking for conservation purposes, and adjustments in use during a permit period which do not result in the prescribed maximum stocking rate for the unit or reservation being exceeded, shall not require approval by the Regional Area Director until the end of the current permit period, at which time the approval of a revised maximum stocking rate will be required as the basis for allocation and advertisement of grazing privileges for the new permit period.

(1) This form should be prepared at least six months prior to the expiration of the existing permits. In these cases where a Permit Period is not clearly defined it shall be prepared at least every three years.

(2) All Indian lands and government owned range land (under supervision of Bureau of Indian Affairs), usable for grazing but not a part of a farm or farm pasture shall be included within a range unit boundary although in some instances the Indian land presently is not included in the grazing permit.

(3) Prepare in triplicate with maps and submit to Regional Director for approval

(4) A map of all range units in triplicate must be prepared and be of a size large enough to specifically delineate the exact boundaries of each range unit.

(5) The original is for the Agency records, the remaining copies are for Regional and Central Office files.

(6) COLUMN 1. Should show the range unit number, and when applicable, the sub‑unit designations (such as 1a, 1b, and 1c). Include units set aside exclusively for wildlife and so designate. After filling in the necessary figures on the sub‑unit lines ( 1a, 1b, and 1c respectively) show total for each unit on separate line. Insert the word TOTAL in the left hand margin on this line or leave next line blank so that totals of each unit are identifiable.

(7) Acres shown in columns 2 through 6 represent only range land in units. (See 25 CFR 166.10).

(8) The figures in column 6 have no bearing in the computation of column 9 (surface acres per cow month).

(9) Column 6 "Usable Range" acres should not include range land not used by livestock because of lack of adequate water facilities. Acres excluded from usable range are barren, waste, inaccessible and timber lands not used for grazing.

(10) Under columns 7 when a sub‑unit is used intermittently throughout the year show the different seasons of use and group by using brackets ( ) to indicate the total number of months used in column B and the surface acres per cow month in column 9.

(11) Column 9 is obtained by dividing column 10 into column 5. Show to nearest tenth acre.

(12) At the bottom of the page show the totals in columns 1, 2, 3, 4, 5, 10 and 11 by adding only the TOTAL line for each range unit. Column 1 is obtained by counting the number of range units on the reservation. (Do not include the sub‑units).

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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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.

FORM 5-5526			STOCKING RATE ON INDIAN LAND IN RANGE UNITS
PAGE__________				RATIO CATTLE TO				RESERVATION ________________________

RECOMMENDED BY ___________________________________				HORSES ______________________________				AGENCY_____________________________
	SUPERINTENDENT

APPROVED BY _____________________				SHEEP AND GOATS _____________________				EFFECTIVE DATE ______________________
	REGIONAL DIRECTOR

Range Unit Number or Sub-Unit Designation	AREA OF RANGE IN ACRES (Do not show fractions)				TOTAL ACRES OF USEABLE RANGE	SEASON OF USE			SURFACE ACRES PER COW MONTH	STOCKING RATE
Range Unit Number or Sub-Unit Designation	Tribal	Allotted	Gov't Owned	Total	TOTAL ACRES OF USEABLE RANGE	FROM	TO	NO. MONTHS	SURFACE ACRES PER COW MONTH	COW MONTH	COW UNIT
1	2	3	4	5	6	7		8*	9	10	11




















TOTAL
* Show to nearest tenth only (3 days equals one tenth)

Form 5-5527 OMB No. 1076-0157

Expires :/31/2006

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF INDIAN AFFAIRS

STOCK COUNTING RECORD

__________________________________________ Reservation ____________________________________

(Name of reservation) (State)

1. Owner's name ____________________________________ _______________________________________________________

(Name of owner of stock)

2. Range unit or area

(Name and local description, if practicable)

3. Date counted ___________________________________

4, Kind of stock .(Cattle, horses, sheep, or goats) _______________________

5. Number of stock ___________________________

6. Place where counted ______________________________________________________________________________________________

(describe accurately)

7. Brands and where located __________________________________________________________________________________________

(Left‑shoulder, left side, etc.)

8. Condition of stock (Indicate poor, fair, good, or excellent)______________________________________

9. Herder's name _______________________________ Address_____________________________________________________________

I hereby certify that the above stock were counted on the date mentioned and that the above is a true and correct count.

_______________________________________ _____________________________________________ _________________

Name Official title Date

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 understand directions, gather the information and fill out the form. If you wish to make comments on the form, please send them to the Information Collection Clearance Officer, Bureau of Indian Affairs, 625 Herndon Parkway, Herndon, VA 20170. 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.

Form 5-5528 OMB No. 1076-0157

Expires: 12/31/2006

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF INDIAN AFFAIRS

LIVESTOCK CROSSING PERMIT

__________________________ Agency ___________________________ Reservation Dated: ____________________

Permission is hereby granted to: _______________________________ _____________________________________

(Name) (Address)

To drive across the above reservation---

Date enter reservation: _______________________________ Date leave reservation: ______________________

By the following route:___________________________________________________________________________

This permit is subject to applicable State and Federal laws and regulations dealing with quarantine and the movement of livestock and to such special instructions as may be issued by the Superintendent of the Agency or his duly authorized representative. No authority is granted to cross trust Indian lands unless specifically set out in this permit. The following charge(s) is made for this crossing privilege:

Issued at the above Agency.

____________________________________________

(Superintendent)

UNITED STATES

DEPARTMENT OF THE INTERIOR

Bureau of Indian Affairs

REMOVABLE RANGE IMPROVEMENTS RECORDS

Reservation __________________________________________ Range Unit No. _______________

It is hereby certified that the following removable improvements have been constructed on Indian trust land or government owned land on the above range unit during previous grazing permit periods and that I (we) claim ownership of said improvements. (Show location on plat on reverse side.)

Improvement Number of Miles Description Estimated Value

Fence:

Pumping Equipment:

Tanks:

Corrals:

Other:

The following removable improvements will be constructed (or purchased) oh Indian trust land or government lands in the unit during the current permit period ________to_______ (Show location on plat on reverse side)

Improvement Number or miles Description Estimated Value

Fence

Other

Authority is hereby requested to remove all the above improvements upon expiration of the grazing permit, provided my occupancy has been satisfactory, and it is understood that any improvements not shown in the above list will remain on the ground and become property of the land. It is further understood and agreed that all wells and casing placed on the range unit will be capped upon expiration of the permit contract in such manner that the succeeding pemittee will be able to Use the well. All the above improvements will be removed within thirty days of the expiration of the permit unless the time is extended by the Superintendent. Improvements not removed within the time limit become the property of the landowner.

________________________________________

Approved: Permittee

_________________________________________ _______________________________________

Superintendent Date: