Form 5460-17
(December 2019)
UNITED STATES
DEPARTMENT OF THE INTERIOR
FORM APPROVED OMB
No. 1004-0058
Expires: November 30, 2022
BUREAU OF LAND MANAGEMENT
Purchaser or Affiliate
SUBSTITUTION DETERMINATION
Contract Number
Location of Processing Facility
In compliance with requirements of 43 Code of Federal Regulations 5424.1, I We hereby submit the following information with
regard to timber from lands tributary* to the above processing facility:
1. Historical Base Determination:
a. Volume of last export sale.
b. Date of last export sale.
c. Total volume of exported private timber in preceding twelve
(12) months from date in b, above. (Exclude volume of last export sale.)
d. Total volume of Federal timber purchased or otherwise acquired in
preceding twelve (12) months from date in b, above.
(MBF)
(MBF)
(MBF)
2. Timber Transactions Since Historical Base Period:
a. Total volume of private timber exported in succeeding twelve (12)
(MBF)
months from date in lb, above. (Include volume of last export sale.)
b. Total volume of Federal timber purchased or otherwise acquired in
(MBF)
succeeding twelve (12) months from date in lb, above.
3. Guide to determine if substitution has occurred, complete the following table (Purchaser’s Option)
a.
MBF exported timber from base period (same as lc, above)
b.
MBF Federal acquisitions from base period (same as 1d, above)
MBF exported timber after base period (same as 2a, above)
c.
d.
MBF Federal acquisitions after base period (same as 2b, above)
If c is greater than a, and d is greater than b, substitution of Federal timber for exported private timber has occurred.
4. The above volumes were determined by:
SCALED BY
SCALING METHODS
Company Employee
Log Scale Rule Used
Scaling Bureau
Maximum Length Without Taper
Other (specify)
Taper Allowance
Comments (If additional space is needed, use page 2)
Name of Firm
Signature of Signing Officer
Title
Date
INSTRUCTIONS
To determine substitution, complete the above and return twelve (12) Specify type of rule used, long log or short log. If volume was sold on a
months from date of last export sale. Report volumes of timber in (MBF).
scale basis, state scaling method.
Do not include exempted species.
*Tributary lands mean area from which timber is expected to be delivered to a given processing facility.
(Continued on Page 2)
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