Form 5-5525 Authority to Grant Grazing Privileges on Allotted Lands

Form 5-5525

	UNITED STATES	OMB # 1076-0157
Reservation:	DEPARTMENT OF THE INTERIOR	OMB # Expires **/**/****
Agency:	BUREAU OF INDIAN AFFAIRS
Landowner:
Landowner ID No.:

AUTHORITY TO GRANT GRAZING PRIVILEGES ON ALLOTTED LANDS

I hereby authorize the Bureau of Indian Affairs (BIA) to include the following lands in range units on the above-cited Reservation and to permit these lands for grazing under provisions of Part 166 of Title 25 Code of Federal Regulations (25 CFR 166) at rental rates established by the BIA under 25 CFR 166.400(b)(1).

Allotment #	Description	Sec.	TWP.	RNG.	Ownership Interest

And I do hereby:

- grant the grazing permittee(s) reasonable access to exercise any and all privileges granted through their permit to graze livestock on the above allotments;

- grant reasonable access to BIA personnel to administer grazing permits on the above lands and to exercise the Bureau’s trust responsibility to protect and manage Indian trust lands;

- recognize that this authority will remain in effect until the ownership interest changes, the land is removed from trust status, or this authority is revoked by the Indian landowner(s) through written notice to the Superintendent. Removal of an allotment from the land schedule for a range unit will be effective immediately if all sureties, Indian landowners, and permittee(s) agree; otherwise, the removal will be effective upon the next anniversary date of the permit. If required written notice to permittees of the allotment’s removal is within 180 days of the anniversary date of the permit, the removal of Indian land will be effective 180 days after the written notice; and

- understand the grazing rental arising from permits on the above lands will be paid to the Department of the Interior and distributed in accordance with regulations of the Department of the Interior.

___________________________________________________________ _____________

Signature of Indian Landowner or Legal Representative Date

Paperwork Reduction Act Statement: This form is covered by the Paperwork Reduction Act.  It is used to establish the respective rights and responsibilities of the respondent and the Federal government. The information is provided by respondents to obtain or retain a benefit.  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 an expiration date.  The number and expiration date are at the top right corner of the form.  An agency may not sponsor or conduct, and a person is not required to respond to, a request for information collection unless it displays a currently valid OMB Control Number.  The public reporting burden is estimated to average 20 minutes per respondent.  This includes the time needed to understand the requirements, gather the information, complete the form, and submit it to the Department.  Comments regarding the burden or other aspects of the form may be directed to the Indian Affairs Information Collection Clearance Officer, Office of Regulatory Affairs – Indian Affairs, 1849 C Street, NW, MS-4141, Washington, DC 20240.