Form DI-1926 Application for Permit for Archeological Investigations

DI-1926 (Rev. 11/2020)
Department of the Interior

OMB Control No. 1024-0037
Expiration Date: TBD

APPLICATION FOR PERMIT FOR ARCHEOLOGICAL INVESTIGATIONS
Under the Authority of
The Archaeological Resources Protection Act of 1979
(16 U.S.C. 470aa-mm; 43 CFR 7);
FOR OFFICIAL USE ONLY
Date Received: _____________
Sent for Review: ____________
Control No. _________________

and/or The Antiquities Act of 1906
(P.L. 59-209; 34 Stat. 225; 54 U.S.C. 320301-320303; 43 CFR 3)
and/or the appropriate Bureau-specific statute Such as
The Reclamation Act; The National Park Service Organic Act;
The National Wildlife Refuge System Administration Act;
The Federal Land Policy and Management Act

Instructions: Complete and return two copies of this application form and required attachments to the appropriate State or
Regional Office of the land managing bureau involved. All information requested must be completed before the application will
be considered. Use separate pages if more space is needed to complete a section.
1. Name of applicant (institution, corporation, partnership, individual, or other entity)
2. Mailing address
3. Telephone Number

3A. Alternate Telephone Number
Home

Work

Cell

Home

Work

Cell

4. Email address(es)
5. Nature of archeological work proposed
Survey and Recordation
Limited Testing and/or Collection (project-specific)
Excavation and/or Removal (project-specific)
6. Location of proposed work (attach additional sheets)
a. Description of Federal lands involved. Indicate State, county, and Federal administrative unit. Specify the best
available location data, e.g., GPS coordinates, UTM coordinates, township, range and section (cadastral)
subdivisions, or metes and bounds. Include a readable copy of a map or plan at an appropriate scale showing specific
areas for which permit is desired.
b. Identification of archeological resource(s) or other cultural resource(s) involved (if applicable).
7. Time of Proposed Work
Overall Duration of Project:
From

To

8. Principal Investigator
Name of individual(s) responsible for planning and
generally overseeing field projects, including overall
supervision of staff and overall responsibility for the
professional quality of resource evaluations and
recommendations.

Estimated Duration of Fieldwork:
From
Telephone Number
Work

Cell

Work

Cell

Work

Cell

Email address(es)

9. Field Director
Telephone Number
Name of individual(s) responsible for carrying out field
projects, for technical quality of fieldwork through direct onthe-ground supervision of all aspects of fieldwork and data
Email address(es)
gathering, for proposing resource evaluations and
recommendations for further treatment, and for preparing
field records and descriptive reports.
10. Permit Administrator
Name of individual responsible for fulfilling the terms and
conditions of the permit
(must be legally empowered to obligate applicant
organization).

To

Telephone Number

Email address(es)

Form DI-1926 (Rev. 11/2020)
Department of the Interior

OMB Control No. 1024-0037
Expiration Date: TBD

11. Applicant must include the following attached to the application form.
a.

Description of the purpose, nature, and extent of the work proposed, including how and why it is proposed to be
conducted: (include research design, methods, curation);

b.

Summary of organizational capabilities, including information on location(s) and description of facilities and
equipment, on organizational structure and staffing, and on facilities, equipment and staff to be involved in the
proposed work;

c.

Summary of organizational history in completing work of the kind proposed, including similar past projects,
government contracts, and Federal permits (previously held, currently in force with effective dates, and currently
pending or planned, by agency and region/state), reports and/or publications resulting from similar work, and any
other pertinent organizational experience;

d.

For each individual named in 8 and 9 above, a curriculum vitae or similar resume or summary of education,
training, and experience in the kind of work proposed and, in the role, proposed.

e.

Written certification, signed by a properly authorized official of the proposed curatorial facility, attesting to the
facility’s capability and willingness to accept any collections, as applicable, and records, data, photographs, and
other documents generated during the proposed term of the permit, and to assume permanent curatorial
responsibility for such materials on behalf of the United States Government pursuant to 36 CFR 79. In the case
of an application on Indian lands where the Indian Tribe or Indian owner(s) do not wish to take custody, written
consent to undertake curation is required from the Indian Tribe or the Indian owner(s) pursuant to 25 CFR
262.8. Custody of any Native American human remains or cultural items subject to the Native American Graves
Protection and Repatriation Act (NAGPRA), 25 USC 3001-3013, removed from public lands or Indian lands shall
be determined in accordance with NAGPRA and its implementing regulations, 43 CFR 10.

12. Proposed outlet(s) for public written dissemination of the results

13. Signature of individual named in 10

14. Date signed

OMB Control No. 1024-0037
Expiration Date: TBD

Form DI-1926 (Rev. 11/2020)
Department of the Interior

NOTICES
PRIVACY ACT STATEMENT
Authority: 16 U.S.C. 470aa-mm; 43 CFR 7, The Archaeological Resources Protection Act of 1979; P.L. 59-209; 34 Stat. 225; 54
U.S.C. 320301-320303; 43 CFR 3, The Antiquities Act of 1906; 54 U.S.C. 100701 Protection, interpretation, and research in
System.
Purpose: The primary use of the records maintained in the system is to 1.) administer scientific archeological research within areas
administered by Federal land managers and assess individuals’ capabilities and organizational capacities to carry out the research
and 2.) maintain a record of the research performed through the interim and final reports, and arrangements made to care for
collections through the curation agreement.
Routine Uses: In addition to those disclosures generally permitted under 5 U.S.C.552a(b) of the Privacy Act, records or
information contained in this system may be disclosed outside DOI or other Federal agencies as a routine use pursuant to 5 U.S.C.
552a(b)(3) to other federal, state, local, tribal or foreign governments and organizations, and members of the general public based
on an authorized routine use when the disclosure is compatible with the purpose for which the records were compiled as described
under the system of records notice for this system.
Disclosure: Voluntary, however, failure to provide the requested information may impede the institution, corporation, partnership,
individual, or other entity from obtaining a permit for archeological investigations.
PAPERWORK REDUCTION ACT STATEMENT
This information is being collected pursuant to 16 U.S.C. 470cc and 470mm, to provide the necessary facts to enable the
Federal land manager (1) to evaluate the applicant’s professional qualifications and organizational capability to conduct the
proposed archeological work; (2) to determine whether the proposed work would be in the public interest; (3) to verify the
adequacy of arrangements for permanent curatorial preservation, as United States property, of specimens and records
resulting from the proposed work; (4) to ensure that the proposed activities would not be inconsistent with any management
plan applicable to the public lands involved; to reports to Congress on Federal Archeology Programs; and (6) to allow Federal
agencies to evaluate Federal archeological protection programs and assess compliance with the Archaeological Resources
Protection Act of 1979 (16 U.S.C. 470cc). Submission of the information is required before the applicant may enjoy the benefit
of using publicly owned archeological resources. To conduct such activities without a permit is punishable by felony-level
criminal penalties, civil penalties, and forfeiture of property. A federal agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a valid OMB control number. OMB has approved this
collection of information and assigned Control No. 1024-0037.
ESTIMATED BURDEN STATEMENT
Public reporting for this collection of information is estimated to average 8 hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden, to the Information Collection Clearance Officer,
National Park Service, 12201 Sunrise Valley Drive Reston, Virginia 20192. Do not send your completed form to this
address.