Form 2540-1
(September 2019)
Act of December 22, 1928, as amended July 28, 1953, 43 U.S.C. 1068
OMB NO. 1004-0029
Expires: October 31, 2021
Serial Number
3. Phone (include area code)
1. Name of applicant (rst, middle initial, and last) 2. Address (include zip code)
4. Legal description of lands claimed
Meridian County State
Acres (number)
Class 2
Class 1 Both
5. Type of application:
6. Are you the record titleholder?
No (if “no,” explain)
7. By what written instrument do you assert ownership (deed, will, court order, etc.) ? Attach copy of instrument to application
8. On what date did you rst learn that you did not have clear title?
9. From what source did you obtain this information?
10a. Have you had title to the lands searched?
No (if yes, please complete the following information about the examiner)
10b. Name
10d. Address (include zip code)
10c. Phone (include area code)
10e. Date of examination
11a. Total purchase price paid by you for above-described property $
11b. Estimated value of structural and cultural improvements on date of purchase
11c. Estimated value of existing structural and cultural improvements added since
11d. Amount received for forest products sold since purchased $
Yes No
12a. Is the land currently under cultivation?
13a. Specify which calendar years cultivated
13b. Acres cultivated (number)
14. List any improvements to property
(Continued on page 2)
(Form 2540-1, page 1)
15. If claim originated before January 1, 1901, are you also applying for the mineral estate? Yes No Not applicable
(Complete only if claim originated before January 1,1901)
16. Enclose the following:
a. A ling fee of $10
b. Form 2540-2 showing all conveyances affecting title to lands
c. Form 2540-3 showing levy and payment of taxes for each year of claim (Required of Class 2 claimants only)
I CERTIFY That the statements made by me in this application are true, complete, and correct to the best of my knowledge and belief and are made in
good faith.
(Date) (Signature of Applicant)
Title 18 U.S.C. Section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency of the United States any false,
ctitious, or fraudulent statements or representations as to any matter within its jurisdiction.
Type or print plainly in ink. Do not submit abstracts of title with this application. Such evidence may
be requested later and, if so, will be returned to you.
(Items not listed are self-explanatory)
4. Give complete legal description of the land
(a) Surveyed land must be described by legal subdivision, section,
township, range, and meridian;
(b) Unsurveyed land must be described by metes and bounds as
accurately as possible, giving length and direction of each of the
boundaries in the tract; description of each of the several corners;
and position of land with reference to established survey mon-
uments, towns, roads, creeks, rivers, mountain peaks, or other
prominent topographic points, natural objects, or other points of
reference; nal action will be suspended until plat of survey is led.
Acreage applied for must not exceed 160 acres.
5. Claims for
Class 1 must be held under under claim or color-of-title for at least
twenty (20) years and must have either valuable improvements or
Class 2 must have originated before January 1, 1901, and must show
levy and payment of taxes during entire period of claim (43 CFR
6. Explain your interest only if you are not claiming land as record
title owner. Attach additional sheet if needed.
1la. Do not include price paid for other lands that may have been included
in same purchase.
16a. Application will not be considered led without payment of $10
ling fee which is nonreturnable. Make check, money order, or bank
draft payable to the Bureau of Land Management.
b. Be sure that all conveyances and claims of title, both record and
nonrecord are itemized.
c. Class 2 claimants only: Be sure every year covered by claim is
accounted for.
(Continued on page 3)
(Form 2540-1, page 2)
The Privacy Act of 1974 and the regulation in 43 CFR 2.48 (d) require that you be furnished the following information in
connection with information required by this application.
AUTHORITY: 43 U.S.C. 1068
PRINCIPAL PURPOSE: The information is to be used to process your application and to document the administrative action
relating to the application.
ROUTINE USES: In accordance with the System of Records titled, “Land and Minerals Authorization Tracking System—
Interior, LLM-32,” disclosure outside the Department of the Interior may be made: (1) To appropriate Federal agencies when
concurrence or supporting information is required prior to granting or acquiring a right or interest in lands or resources, (2) To
Federal, State, or local agencies or a member of the general public in response to a specic request for pertinent information,
(3) To the U.S. Department of Justice or in a proceeding before a court or adjudicative body when (a) the United States, the
Department of the Interior, a component of the Department, or when represented by the government, an employee of the
Department is a party to litigation or anticipated litigation or has an interest in such litigation, and (b) the Department of
the Interior determines that the disclosure is relevant or necessary to the litigation and is compatible with the purpose for
which the records were compiled, (4) To an appropriate Federal, State, local, or foreign agency responsible for investigating,
prosecuting, enforcing, or implementing a statute, regulation, rule, or order, where the disclosing agency becomes aware of
an indication of a violation or potential violation of civil or criminal law or regulation, (5) To a member of Congress or a
Congressional staff member from the record of an individual in response to an inquiry made at the request of that individual,
(6) To the Department of the Treasury to effect payment to Federal, State, and local government agencies, nongovernmental
organizations, and individuals, and (7) To individuals involved in responding to a breach of Federal data. The BLM will only
disclose this information in accordance with the Freedom of Information Act, the Privacy Act, and the provision in 43 CFR
The Paperwork Reduction Act of 1995 requires us to inform you that:
BLM collects this information to process your request for Federal lands under the provisions of the Color-of-Title Regulations,
found in 43 CFR Section 2540.
Information will be used to illustrate whether the applicant meets requirements of regulations found in 43 CFR Subpart 2540,
Subparts 2541-2547.
Response to this request is required to obtain a benet, see 43 CFR Subpart 2541.2.
BLM would like you to know that you do not have to respond to this or any other Federal agency-sponsored information
collection unless it displays a currently valid OMB control number.
EFFECT OF NOT PROVIDING INFORMATION: Disclosure of the information is voluntary. If all the information is not
provided, the application may result in delay or preclude the BLM’s acceptance of your form.
BURDEN HOURS STATEMENT: Public reporting burden for this form is estimated at 1 hour per response, including the
time for reviewing instructions, gathering, and maintaining data and completing and reviewing the form. Direct comments
regarding the burden estimate or any other aspect of this form to the U.S. Department of the Interior, Bureau of Land
Management (1004-0012), Bureau Information Collection Clearance Ofcer (WO-630), 1849 C Street, N.W., Mail Stop 401
LS, Washington, D.C. 20240.
(Form 2540-1, page 3)