1076-0017 |
Application for Financial Assistance and Social Services |
Any individual or family may apply for BIA Financial Assistance and Social Services by completing the application process with the assistance of the Social Worker. A Word version of the Application for Financial Assistance and Social Services (FASS) and Individual Self-Sufficiency (ISP)/Case Plan is available on the Division of Human Services website: https://www.bia.gov/bia/ois/dhs/financial-assistance. |
1076-0017 |
Individual Self-Sufficiency Plan (ISP)/Case Plan |
Any individual or family may apply for BIA Financial Assistance and Social Services by completing the application process with the assistance of the Social Worker. A Word version of the Application for Financial Assistance and Social Services (FASS) and Individual Self-Sufficiency (ISP)/Case Plan is available on the Division of Human Services website: https://www.bia.gov/bia/ois/dhs/financial-assistance. |
1076-0018 |
Tribal Colleges & Universities (TCU) Annual Report Form and Instructions |
The Tribally Controlled Community College Assistance Act of 1978 (25 U.S.C. 1802-1815) allows for tribally controlled community colleges to apply for grants for the purpose of ensuring continued and expanded education opportunities for American Indian and Alaska Native students. The implementing regulations at 25 CFR 41 establishes the process for tribally controlled colleges to apply for the grants. For more information, please visit www.bie.edu. |
1076-0018 |
Tribal Colleges & Universities (TCU) Application |
The Tribally Controlled Community College Assistance Act of 1978 (25 U.S.C. 1802-1815) allows for tribally controlled community colleges to apply for grants for the purpose of ensuring continued and expanded education opportunities for American Indian and Alaska Native students. The implementing regulations at 25 CFR 41 establishes the process for tribally controlled colleges to apply for the grants. For more information, please visit www.bie.edu. |
1076-0018 |
Tribal Colleges & Universities (TCU) Enrollment Spreadsheet (in Excel) |
The Tribally Controlled Community College Assistance Act of 1978 (25 U.S.C. 1802-1815) allows for tribally controlled community colleges to apply for grants for the purpose of ensuring continued and expanded education opportunities for American Indian and Alaska Native students. The implementing regulations at 25 CFR 41 establishes the process for tribally controlled colleges to apply for the grants. For more information, please visit www.bie.edu. |
1076-0018 |
Tribal Colleges & Universities (TCU) Indian Student Count (ISC) Form (in Excel) |
The Tribally Controlled Community College Assistance Act of 1978 (25 U.S.C. 1802-1815) allows for tribally controlled community colleges to apply for grants for the purpose of ensuring continued and expanded education opportunities for American Indian and Alaska Native students. The implementing regulations at 25 CFR 41 establishes the process for tribally controlled colleges to apply for the grants. For more information, please visit www.bie.edu. |
1076-0020 |
Assignment of Loan Documents and Related Rights |
The Office of Indian Energy and Economic Development (IEED) implements the Loan Guarantee, Insurance, and Interest Subsidy Program, 25 U.S.C. 1451, et seq., the purpose of which is to encourage private lending to individual Indians and Indian organizations by providing lenders with loan guarantees or loan insurance to reduce their potential risk. The forms associated with this collection allows IEED to determine the eligibility and credit-worthiness of respondents and loans and otherwise ensure compliance with program requirements.
The forms are available on the Division of Capital Investment website here: https://www.bia.gov/service/loans/ilgp |
1076-0020 |
Claim for Loss |
The Office of Indian Energy and Economic Development (IEED) implements the Loan Guarantee, Insurance, and Interest Subsidy Program, 25 U.S.C. 1451, et seq., the purpose of which is to encourage private lending to individual Indians and Indian organizations by providing lenders with loan guarantees or loan insurance to reduce their potential risk. The forms associated with this collection allows IEED to determine the eligibility and credit-worthiness of respondents and loans and otherwise ensure compliance with program requirements.
The forms are available on the Division of Capital Investment website here: https://www.bia.gov/service/loans/ilgp |
1076-0020 |
Interest Subsidy Report |
The Office of Indian Energy and Economic Development (IEED) implements the Loan Guarantee, Insurance, and Interest Subsidy Program, 25 U.S.C. 1451, et seq., the purpose of which is to encourage private lending to individual Indians and Indian organizations by providing lenders with loan guarantees or loan insurance to reduce their potential risk. The forms associated with this collection allows IEED to determine the eligibility and credit-worthiness of respondents and loans and otherwise ensure compliance with program requirements.
The forms are available on the Division of Capital Investment website here: https://www.bia.gov/service/loans/ilgp |
1076-0020 |
Loan Guarantee Agreement |
The Office of Indian Energy and Economic Development (IEED) implements the Loan Guarantee, Insurance, and Interest Subsidy Program, 25 U.S.C. 1451, et seq., the purpose of which is to encourage private lending to individual Indians and Indian organizations by providing lenders with loan guarantees or loan insurance to reduce their potential risk. The forms associated with this collection allows IEED to determine the eligibility and credit-worthiness of respondents and loans and otherwise ensure compliance with program requirements.
The forms are available on the Division of Capital Investment website here: https://www.bia.gov/service/loans/ilgp |
1076-0020 |
Loan Insurance Agreement |
The Office of Indian Energy and Economic Development (IEED) implements the Loan Guarantee, Insurance, and Interest Subsidy Program, 25 U.S.C. 1451, et seq., the purpose of which is to encourage private lending to individual Indians and Indian organizations by providing lenders with loan guarantees or loan insurance to reduce their potential risk. The forms associated with this collection allows IEED to determine the eligibility and credit-worthiness of respondents and loans and otherwise ensure compliance with program requirements.
The forms are available on the Division of Capital Investment website here: https://www.bia.gov/service/loans/ilgp |
1076-0020 |
Notice of Default |
The Office of Indian Energy and Economic Development (IEED) implements the Loan Guarantee, Insurance, and Interest Subsidy Program, 25 U.S.C. 1451, et seq., the purpose of which is to encourage private lending to individual Indians and Indian organizations by providing lenders with loan guarantees or loan insurance to reduce their potential risk. The forms associated with this collection allows IEED to determine the eligibility and credit-worthiness of respondents and loans and otherwise ensure compliance with program requirements.
The forms are available on the Division of Capital Investment website here: https://www.bia.gov/service/loans/ilgp |
1076-0020 |
Notice of Insured Loan |
The Office of Indian Energy and Economic Development (IEED) implements the Loan Guarantee, Insurance, and Interest Subsidy Program, 25 U.S.C. 1451, et seq., the purpose of which is to encourage private lending to individual Indians and Indian organizations by providing lenders with loan guarantees or loan insurance to reduce their potential risk. The forms associated with this collection allows IEED to determine the eligibility and credit-worthiness of respondents and loans and otherwise ensure compliance with program requirements.
The forms are available on the Division of Capital Investment website here: https://www.bia.gov/service/loans/ilgp |
1076-0020 |
Request for Loan Guarantee, Loan Insurance, and/or Interest Subsidy |
The Office of Indian Energy and Economic Development (IEED) implements the Loan Guarantee, Insurance, and Interest Subsidy Program, 25 U.S.C. 1451, et seq., the purpose of which is to encourage private lending to individual Indians and Indian organizations by providing lenders with loan guarantees or loan insurance to reduce their potential risk. The forms associated with this collection allows IEED to determine the eligibility and credit-worthiness of respondents and loans and otherwise ensure compliance with program requirements.
The forms are available on the Division of Capital Investment website here: https://www.bia.gov/service/loans/ilgp |
1076-0021 |
Electrical Service Application |
BIA collects information to operate and maintain it's electric power utilities to serve electric power consumers and to fulfill reporting requirements.
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1076-0047 |
Reindeer Sale Permit and Report Form |
These forms are collected to monitor and regulation the possession and use of Alaskan reindeer by non-Natives in Alaska. An applicant must fill out an application for a permit to get a reindeer for any purpose, and is required to report on the status of reindeer annually or when change occurs, including changing prior to the date of the annual report. |
1076-0047 |
Special Use Permit for Public Display of Alaska Reindeer |
These forms are collected to monitor and regulation the possession and use of Alaskan reindeer by non-Natives in Alaska. An applicant must fill out an application for a permit to get a reindeer for any purpose, and is required to report on the status of reindeer annually or when change occurs, including changing prior to the date of the annual report. |
1076-0047 |
Special Use Reindeer Report |
These forms are collected to monitor and regulation the possession and use of Alaskan reindeer by non-Natives in Alaska. An applicant must fill out an application for a permit to get a reindeer for any purpose, and is required to report on the status of reindeer annually or when change occurs, including changing prior to the date of the annual report. |
1076-0094 |
Dissolution of Marriage Application |
Marriage License Application and Dissolution of Marriage Application |
1076-0094 |
Marriage License Application |
Marriage License Application and Dissolution of Marriage Application |
1076-0104 |
Ancestry Chart (BIA-8305) (MS-Word) |
Groups seeking Federal acknowledgment under 25 CFR 83 may use the following forms under OMB# 1076-0104 (which includes BIA forms 8304 (Individual History Chart), 8305 (Ancestry Chart) and 8306 (Membership Roll)) to provide a complete list of members of the group seeking recognition. Groups may submit the information on their own forms. |
1076-0104 |
Ancestry Chart (BIA-8305) (PDF) |
Groups seeking Federal acknowledgment under 25 CFR 83 may use the following forms under OMB# 1076-0104 (which includes BIA forms 8304 (Individual History Chart), 8305 (Ancestry Chart) and 8306 (Membership Roll)) to provide a complete list of members of the group seeking recognition. Groups may submit the information on their own forms. |
1076-0104 |
Individual History Chart (BIA-8304) (MS-Word) |
Groups seeking Federal acknowledgment under 25 CFR 83 may use the following forms under OMB# 1076-0104 (which includes BIA forms 8304 (Individual History Chart), 8305 (Ancestry Chart) and 8306 (Membership Roll)) to provide a complete list of members of the group seeking recognition. Groups may submit the information on their own forms. |
1076-0104 |
Individual History Chart (BIA-8304) (PDF) |
Groups seeking Federal acknowledgment under 25 CFR 83 may use the following forms under OMB# 1076-0104 (which includes BIA forms 8304 (Individual History Chart), 8305 (Ancestry Chart) and 8306 (Membership Roll)) to provide a complete list of members of the group seeking recognition. Groups may submit the information on their own forms. |
1076-0104 |
Membership Roll (BIA-8306) (MS-Word) |
Groups seeking Federal acknowledgment under 25 CFR 83 may use the following forms under OMB# 1076-0104 (which includes BIA forms 8304 (Individual History Chart), 8305 (Ancestry Chart) and 8306 (Membership Roll)) to provide a complete list of members of the group seeking recognition. Groups may submit the information on their own forms. |
1076-0104 |
Membership Roll (BIA-8306) (PDF) |
Groups seeking Federal acknowledgment under 25 CFR 83 may use the following forms under OMB# 1076-0104 (which includes BIA forms 8304 (Individual History Chart), 8305 (Ancestry Chart) and 8306 (Membership Roll)) to provide a complete list of members of the group seeking recognition. Groups may submit the information on their own forms. |
1076-0111 |
Payment for Appointed Counsel in Involuntary Indian Child Custody Proceedings in State Courts, 25 CFR 23.13 |
A State court that appoints counsel for an indigent Indian parent or custodian in an involuntary Indian child custody proceeding in a State court may write to the BIA requesting payment for the counsel's services when State law does not authorize State funds to pay such services. The BIA's Regional Director, in the BIA Region where the case is heard, uses the submitted information to decide whether to certify that the client is eligible to have his counsel compensated by the BIA in accordance with the Indian Child Welfare Act, Public Law 95-608. |
1076-0114 |
Haskell Indian Nations University Admission Application |
For more information regarding admission to Haskell Indian Nations University, please visit Haskell's website: https://www.haskell.edu/.
For more information regarding admission to Southwestern Indian Polytechnic Institute (SIPI), please visit SIPI's website: https://www.sipi.edu/.
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1076-0114 |
Southwestern Indian Polytechnic Institute (SIPI) Admission Application |
For more information regarding admission to Haskell Indian Nations University, please visit Haskell's website: https://www.haskell.edu/.
For more information regarding admission to Southwestern Indian Polytechnic Institute (SIPI), please visit SIPI's website: https://www.sipi.edu/. |
1076-0120 |
Adult Education Annual Report Form |
The Bureau of Indian Education (BIE) annually collects information to prioritize programs and measure the success of programs. This annual report helps manage the resources available to provide education opportunities for adult Indians and Alaska Natives to complete high school graduation requirements and gain new skills and knowledge for their self-enhancement. For more information on the Adult Education program, please visit www.bie.edu.
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1076-0122 |
Data Elements for Student Enrollment in Bureau-funded Schools |
This form is used for by Bureau-funded school registrars to collect information to determine student's eligibility for enrollment in a Bureau-funded school. If eligible, the information is shared with appropriate schools officials to identify the student's base and supplemental educational and/or residential program needs. |
1076-0131 |
Indian Child Welfare Quarterly and Annual Report |
The BIA collects information using the consolidated caseload form, which tribal ICWA program directors complete. BIA uses the information to determine the extent of service needs in local Indian communities, assess ICWA program effectiveness, and provide data for the annual program budget justification.
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1076-0134 |
BIE Indian School Equalization Program (ISEP) Student Transportation Form |
This form is used by Bureau-funded Schools to determine the rate per mile and allocation of transportation funds. The Student Transportation regulations in 25 CFR part 39, subpart G, contain the program eligibility and criteria that govern the allocation of transportation funds. This information is also collected using a web-based system, Web Education Transportation (Web ET).
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1076-0135 |
477 Financial Report Form and Instructions (Excel) |
Reporting System for P.L. 102-477 Demonstration Project |
1076-0135 |
477 Narrative Report |
Reporting System for P.L. 102-477 Demonstration Project |
1076-0135 |
477 Statistical Report and Instructions |
Reporting System for P.L. 102-477 Demonstration Project |
1076-0141 |
Agreement for Carriage of Water |
In order for irrigators to receive water deliveries, information is needed by the BIA to operate and maintain its irrigation projects and fulfill reporting requirements. Water users must apply for water delivery and for a number of other associated services, such as, subsidizing a farm unit, requesting leaching service, requesting water for domestic or stock purposes, building structures or fences in BIA rights-of-way, requesting payment plans on bills, establishing a carriage agreement with a third-party, negotiating irrigation incentives leases, and requesting an assessment waiver. |
1076-0141 |
Annual Assessment Waiver Application |
In order for irrigators to receive water deliveries, information is needed by the BIA to operate and maintain its irrigation projects and fulfill reporting requirements. Water users must apply for water delivery and for a number of other associated services, such as, subsidizing a farm unit, requesting leaching service, requesting water for domestic or stock purposes, building structures or fences in BIA rights-of-way, requesting payment plans on bills, establishing a carriage agreement with a third-party, negotiating irrigation incentives leases, and requesting an assessment waiver. |
1076-0141 |
Incentive Agreement |
In order for irrigators to receive water deliveries, information is needed by the BIA to operate and maintain its irrigation projects and fulfill reporting requirements. Water users must apply for water delivery and for a number of other associated services, such as, subsidizing a farm unit, requesting leaching service, requesting water for domestic or stock purposes, building structures or fences in BIA rights-of-way, requesting payment plans on bills, establishing a carriage agreement with a third-party, negotiating irrigation incentives leases, and requesting an assessment waiver. |
1076-0141 |
Land Classification/Designation Application |
In order for irrigators to receive water deliveries, information is needed by the BIA to operate and maintain its irrigation projects and fulfill reporting requirements. Water users must apply for water delivery and for a number of other associated services, such as, subsidizing a farm unit, requesting leaching service, requesting water for domestic or stock purposes, building structures or fences in BIA rights-of-way, requesting payment plans on bills, establishing a carriage agreement with a third-party, negotiating irrigation incentives leases, and requesting an assessment waiver. |
1076-0141 |
Request for Customer Information |
In order for irrigators to receive water deliveries, information is needed by the BIA to operate and maintain its irrigation projects and fulfill reporting requirements. Water users must apply for water delivery and for a number of other associated services, such as, subsidizing a farm unit, requesting leaching service, requesting water for domestic or stock purposes, building structures or fences in BIA rights-of-way, requesting payment plans on bills, establishing a carriage agreement with a third-party, negotiating irrigation incentives leases, and requesting an assessment waiver. |
1076-0141 |
Request for Irrigation Services |
In order for irrigators to receive water deliveries, information is needed by the BIA to operate and maintain its irrigation projects and fulfill reporting requirements. Water users must apply for water delivery and for a number of other associated services, such as, subsidizing a farm unit, requesting leaching service, requesting water for domestic or stock purposes, building structures or fences in BIA rights-of-way, requesting payment plans on bills, establishing a carriage agreement with a third-party, negotiating irrigation incentives leases, and requesting an assessment waiver. |
1076-0143 |
Self-Governance Minimum Data Collection |
Tribes and Tribal consortia that have entered into Self-Governance funding agreements are requested to submit certain information as described in 25 CFR part 1000.
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1076-0153 |
Certificate of Degree of Indian or Alaska Native Blood (CDIB) (PDF) |
This is the Certificate of Degree of Indian or Alaska Native Blood (CDIB) form. Instructions are included with the form.
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1076-0157 |
Form 5-5243 - Performance Bond |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5514 - Bid for Grazing Privileges |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5515 - Grazing Permit |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5516 - Grazing Permit for Organized Tribes |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5517 - Free Grazing Permit |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5519 - Cash Penal Bond for Grazing Permits |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5520 - Power of Attorney |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5521 - Certificate and Application for On-and-Off Grazing Permit |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5522 - Modification of Grazing Permit (Form 5-5515) |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5523 - Assignment of Grazing Permit |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5524 - Application for Allocation of Grazing Privileges |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5525 - Authority to Grant Grazing Privileges on Allotted Lands |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5528 - Livestock Crossing Permit |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0157 |
Form 5-5529 - Removable Range Improvement Records |
Grazing Permits
The parties submitting information are Tribes, Tribal organizations authorized by Indian Tribal governments, individual Indians, and non-Indians seeking grazing permits on land held by the U.S. Government in trust for Tribes and individual indians.
The Bureau of Indian Affairs (BIA) uses the information provided through these forms, approved under OMB# 1076-0157, to issue and administer grazing permits on Indian trust lands under the regulations at 25 CFR 166. Individuals seeking grazing permits provide information such as: name, address, phone number, number of livestock owned, type of livestock, class of livestock, season of use, brand information, brand ownership, brand location, grazing fee bid information, range improvement location and value, and information relating to permit violations or livestock trespass. |
1076-0160 |
Family History Chart |
Applicants seeking employment in the Indian Health Service and/or Indian Affairs use this form to establish evidence of Indian preference as part of the application process. The Family History Chart is also used as part of the Indian Preference verification process. |
1076-0160 |
Verification of Indian Preference for Employment in the BIA or IHS |
Also referred to as "BIA 4432", this form is used by applicants seeking employment in the Indian Health Service and/or Indian Affairs to establish evidence of Indian preference as part of the application process. The Family History Chart is also used as part of the Indian Preference verification process. |
1076-0162 |
Navajo Partitioned Lands: Grazing Permit Modification/Transfer Agreement (Form 5-5022) |
This information is used by the Department of the Interior (DOI), Bureau of Indian Affairs (BIA), and the Navajo Nation to determine eligibility for a Navajo Partitioned Land (NPL) grazing permit and to administer permits once issues. Information is submitted by individual Navajo tribal members wanting to obtain or modify a grazing permit and by departments and officials of the Navajo Nation. |
1076-0162 |
Navajo Partitioned Lands: Grazing Permits (Form 5-5015) |
This information is used by the Department of the Interior (DOI), Bureau of Indian Affairs (BIA), and the Navajo Nation to determine eligibility for a Navajo Partitioned Land (NPL) grazing permit and to administer permits once issues. Information is submitted by individual Navajo tribal members wanting to obtain or modify a grazing permit and by departments and officials of the Navajo Nation. |
1076-0164 |
Authorization for Medical Care of a Minor |
This is a BIE form which gives permission for a physician, surgeon, or dentist to provide necessary care to a child whose parents are not immediately available. |
1076-0176 |
IDEIA Tribal Count Data Requirements for Part B |
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1076-0176 |
IDEIA Tribal Count Data Requirements Part C |
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1076-0179 |
BIE Advisory Board for Exceptional Education Membership Nomination Form |
This form is used to submit nominations for individuals to serve on the Federal advisory committee, the Advisory Board for Exceptional Children.
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1076-0180 |
Application for Permit to Drill Environmental Assessment Questionnaire |
The United States holds the subsurface mineral estate in Osage County, Oklahoma (Osage Mineral Estate) in trust for the benefit of the Osage Nation. The regulations set forth in 25 CFR 226, implement that statute by specifying what information a lessee must provide related to drilling, development, and production of oil and gas on Osage reservation land. The BIA collects this information to administer the leasing and development of the Osage Mineral Estate as well as to ensure that all royalties and revenues derived from the Osage Mineral Estate are collected and accounted for and that the oil and gas trust assets, surface estate, natural resources, and human environment are adequately protected. |
1076-0180 |
Form 139 - Application for Permit to Drill or Reenter |
The United States holds the subsurface mineral estate in Osage County, Oklahoma (Osage Mineral Estate) in trust for the benefit of the Osage Nation. The regulations set forth in 25 CFR 226, implement that statute by specifying what information a lessee must provide related to drilling, development, and production of oil and gas on Osage reservation land. The BIA collects this information to administer the leasing and development of the Osage Mineral Estate as well as to ensure that all royalties and revenues derived from the Osage Mineral Estate are collected and accounted for and that the oil and gas trust assets, surface estate, natural resources, and human environment are adequately protected. |
1076-0180 |
Form 208 - Well Completion or Recompletion Report and Log |
The United States holds the subsurface mineral estate in Osage County, Oklahoma (Osage Mineral Estate) in trust for the benefit of the Osage Nation. The regulations set forth in 25 CFR 226, implement that statute by specifying what information a lessee must provide related to drilling, development, and production of oil and gas on Osage reservation land. The BIA collects this information to administer the leasing and development of the Osage Mineral Estate as well as to ensure that all royalties and revenues derived from the Osage Mineral Estate are collected and accounted for and that the oil and gas trust assets, surface estate, natural resources, and human environment are adequately protected. |
1076-0180 |
Form 229 - Waterflood Operating Report |
The United States holds the subsurface mineral estate in Osage County, Oklahoma (Osage Mineral Estate) in trust for the benefit of the Osage Nation. The regulations set forth in 25 CFR 226, implement that statute by specifying what information a lessee must provide related to drilling, development, and production of oil and gas on Osage reservation land. The BIA collects this information to administer the leasing and development of the Osage Mineral Estate as well as to ensure that all royalties and revenues derived from the Osage Mineral Estate are collected and accounted for and that the oil and gas trust assets, surface estate, natural resources, and human environment are adequately protected. |
1076-0180 |
Form A - Osage Gas Mining Lease |
The United States holds the subsurface mineral estate in Osage County, Oklahoma (Osage Mineral Estate) in trust for the benefit of the Osage Nation. The regulations set forth in 25 CFR 226, implement that statute by specifying what information a lessee must provide related to drilling, development, and production of oil and gas on Osage reservation land. The BIA collects this information to administer the leasing and development of the Osage Mineral Estate as well as to ensure that all royalties and revenues derived from the Osage Mineral Estate are collected and accounted for and that the oil and gas trust assets, surface estate, natural resources, and human environment are adequately protected. |
1076-0180 |
Form B - Osage Oil Mining Lease |
The United States holds the subsurface mineral estate in Osage County, Oklahoma (Osage Mineral Estate) in trust for the benefit of the Osage Nation. The regulations set forth in 25 CFR 226, implement that statute by specifying what information a lessee must provide related to drilling, development, and production of oil and gas on Osage reservation land. The BIA collects this information to administer the leasing and development of the Osage Mineral Estate as well as to ensure that all royalties and revenues derived from the Osage Mineral Estate are collected and accounted for and that the oil and gas trust assets, surface estate, natural resources, and human environment are adequately protected. |
1076-0180 |
Form C - Osage Oil and Gas Mining Lease |
The United States holds the subsurface mineral estate in Osage County, Oklahoma (Osage Mineral Estate) in trust for the benefit of the Osage Nation. The regulations set forth in 25 CFR 226, implement that statute by specifying what information a lessee must provide related to drilling, development, and production of oil and gas on Osage reservation land. The BIA collects this information to administer the leasing and development of the Osage Mineral Estate as well as to ensure that all royalties and revenues derived from the Osage Mineral Estate are collected and accounted for and that the oil and gas trust assets, surface estate, natural resources, and human environment are adequately protected. |
1076-0180 |
Form D - Osage Mining Leases Bond |
The United States holds the subsurface mineral estate in Osage County, Oklahoma (Osage Mineral Estate) in trust for the benefit of the Osage Nation. The regulations set forth in 25 CFR 226, implement that statute by specifying what information a lessee must provide related to drilling, development, and production of oil and gas on Osage reservation land. The BIA collects this information to administer the leasing and development of the Osage Mineral Estate as well as to ensure that all royalties and revenues derived from the Osage Mineral Estate are collected and accounted for and that the oil and gas trust assets, surface estate, natural resources, and human environment are adequately protected. |
1076-0180 |
Form E - Evidence of Authority of Officers to Execute Papers |
The United States holds the subsurface mineral estate in Osage County, Oklahoma (Osage Mineral Estate) in trust for the benefit of the Osage Nation. The regulations set forth in 25 CFR 226, implement that statute by specifying what information a lessee must provide related to drilling, development, and production of oil and gas on Osage reservation land. The BIA collects this information to administer the leasing and development of the Osage Mineral Estate as well as to ensure that all royalties and revenues derived from the Osage Mineral Estate are collected and accounted for and that the oil and gas trust assets, surface estate, natural resources, and human environment are adequately protected. |