An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

IA Paperwork Reduction Act (PRA)

Forms

NOTE: forms that are noted below as being in MS-Word or Excel format should be opened using Google Chrome (due to issues with Internet Explorer (IE) and Excel/Word)

OMB Control Number Title Description
1076-0180 Form F - Assignment of Lease Form

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.

Form G - Osage Mining Leases Collective Bond
Form H - Bond to Accompany Assignment of Mining Leases of Osage Lands
Monthly Accounting Forms (Osage Form No. 133, 157, 300, 101 & 101A)
Osage Assignment of Liability Form
Osage Easement for Saltwater Disposal Well
Osage Lease Status Report (Unplugged Wells Only)
Osage Mineral Reserve Trucking Permit
Osage Mining Lease Modification Form
Osage Spill Reporting and Remediation Form
Osage Tank Bottom Oil Report
Template Letter for List of Corporate Officers
1076-0181 Right-of-Way Application

This application is a request for the BIA to grant a right-of-way to cross land held in trust or restricted status on behalf of individual Indians and tribes under the terms and provisions of 25 U.S.C. 323-328 and 25 CFR 169. Please use Standard Form (SF)-299 for rights-of-way on Federal land.  

1076-0183 Secretarial Election Voter Registration Form

Under the Indian Reorganization Act, Tribes have the right to organize and adopt constitutions, bylaws, and any amendments thereto, and ratify charters of incorporation, through elections called by the Secretary of the Interior (Secretarial election). This form is used by Tribal members to register in an upcoming Secretarial election.

1076-0184 HIP Addendum

Housing Improvement Program (HIP) forms (note: please open any form noted as being in Excel or Word using Chrome (instead of Internet Explorer) due to issues with IE and Excel/Word docs)

HIP GPRA Form (in Excel)
HIP Housing Assistance Application (BIA 6407)
HIP Housing Assistance Application Instructions
Tribal Annual Performance Report (TAPR) - macro-enabled (in Excel)
Tribal Annual Performance Report (TAPR) - non-macro enabled (manual entry only) (in Excel)
1076-0188 Self-Certification of Appraiser Qualifications

An appraiser may complete this self-certification if they meet the criteria in 43 CFR § 100.200.

1076-0190 Child Passenger Safety (CPS) Grant Application and Instructions

The Highway Safety Act of 1966, 23 U.S.C. § 402, provides the Bureau of Indian Affairs (BIA), Office of Justice Services (OJS), Indian Highway Safety Program (IHSP) through the U.S. Department of Transportation (DOT), funding to assist federally recognized tribes in implementing traffic safety projects. Tribes receiving grant awards are required to submit a monthly progress report, including a Request for Reimbursement (RFR) with supporting documentation. The spreadsheet tabulates the data from one month to the next as statistics are entered, and eventually carried into the Annual Report. The spreadsheet was designed to assist the tribes in compiling the data reported on a monthly basis to reduce the tribe’s burden in completing the report at the end of the grant year.

Indian Highway Safety Monthly Report
Indian Highway Safety Program CPS Annual Report
Law Enforcement Grant Application and Instructions
1076-0195 Land Mortgage Lender Loan Checklist

These forms are used as part of the mortgage process, as described in 52 IAM 4-H. These documents are in Word only.

Leasehold Mortgage Lender Checklist

indianaffairs.gov

An official website of the U.S. Department of the Interior

Looking for U.S. government information and services?
Visit USA.gov