Paperwork Reduction Act (PRA) Forms
Title Description

OMB# 1076-0160, Verification of Indian Preference for Employment

OMB# 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.

OMB# 1076-0135

Version 1 (Old Forms)

IA 7701 - Narrative Report

IA 7702 - Statistical Report (Used PRIOR to 2003)

IA 7702 - Statistical Report and Instructions (Currently in Use)

IA 7703 - Financial Report

IA 7703 A - TANF

OMB# 1076-0135 

Version 2 (New Forms)

477 Financial Report Form and Instructions

477 Narrative Report

477 Statistical Report and Instructions

Guidance - P.L. 102-477 Financial Reporting Functional Cost Categories

Reporting System for P.L. 102-477 Demonstration Project  


To ensure a smooth transition from the older version (Version 1) to the new version (Version 2),

BIA will continue to accept both versions until February 28, 2018. 
Version 1 Forms remain available for use until February 2018 to provide flexibility to tribes who may have
existing P.L. 102-477 contracts prior to February 28, 2015.

NOTE: Version 1 Forms will be obsolete starting February 28, 2018 and will be replaced by Version 2 Forms.

Version 2 Forms are available for use for Tribes who have entered into a new P.L. 102-477 contract on or after March 1, 2015.

OMB# 1076-0157

Form 5-5243 - Performance Bond

Form 5-5514 - Bid for Grazing Privileges

Form 5-5515 - Grazing Permit

Form 5-5516 - Grazing Permit for Organized Tribes

Form 5-5517 - Free Grazing Permit

Form 5-5519 - Cash Penal Bond for Grazing Permits

Form 5-5520 - Power of Attorney

Form 5-5521 - Certificate and Application for On-and-Off Grazing Permit

Form 5-5522 - Modification of Grazing Permit (Form 5-5515)

Form 5-5523 - Assignment of Grazing Permit

Form 5-5524 - Application for Allocation of Grazing Privileges

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

Form 5-5528 - Livestock Crossing Permit

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. 

OMB #1076-0184 

Instructions for completing OMB #1076-0184

Housing Improvement Program (HIP) Housing Assistance Application and Instructions