Fill - Free fillable GRAZING PERMIT FOR ORGANIZED TRIBES Usage note: Form (Bureau of Indian Affairs) PDF form

Form 5-5516, Grazing Permit for Organized Tribes, Page 1 of 5

Permittee Initial _____

Form 5-5516 (Revised 6/2013)

Incorporates 5-5518

OMB # 1076-0157

Expires 3/31/2023

Contract No.:

UNITED STATES

Range Unit:

DEPARTMENT OF THE

Agency:

INTERIOR

Reservation:

BUREAU OF INDIAN AFFAIRS

GRAZING PERMIT FOR ORGANIZED TRIBES

Usage note: Form 5-5516 to be used by tribes qualified and equipped to bill and receive fees through direct pay and

to exercise their prerogative to issue permits on range units made up entirely of tribal lands or said lands in

combination with government land.

The __________________________________ Tribe of the ______________________________ Indian

(Name of Organized Tribe) (Name of Reservation)

Reservation, organized under a constitution and bylaws pursuant to section 16 of the Act of June 18,

1934 (48 Stat. 984), and incorporated pursuant to section 17 of said act (Line out reference to

incorporation where charter not issued), by authority of law and under the regulations prescribed by the

Secretary of the Interior at 25 CFR 166, hereby grants permission to

______________________________________ of __________________________________________,

(Name of Permittee) (Mailing Address)

to hold and graze livestock on the tribal land of Range Unit __________________ of the above-identified

(Unit Name or Number)

Reservation for a period beginning ____________ and terminating not later than ____________, and

(Date) (Date)

subject to the livestock kind and number and the grazing season shown on the table below:

UNIT

KIND OF

LIVESTOCK

NUMBER

OF HEAD

GRAZING SEASON

Animal Unit

Months*

PAYMENT

From

Months

Type

Amount

Grazing Rental**

TOTAL RENTAL

Administrative Fee

Tribal Fees

TOTAL FEES

TOTAL PAYMENT

* Animal Unit Months = Number of Head times number of Months. For sheep, divide result by five (5).

**Under 25 CFR 166.408 the Grazing Rental is subject to review and adjustment every _______ year(s)

through the life of the permit.

The annual grazing rental and all applicable fees are due each year on the _____ day of _____________.

The grazing rental is payable to (select one) _____ the Bureau of Indian Affairs (BIA); _____ directly to

the Indian landowners (25 CFR 166.413(c) applies). When payment is made directly to the landowner,

the Administrative Fee is waived per 25 CFR 166.503. When such direct payment is made, the permittee

is required to retain documented proof of payment. Payment made to BIA may be delivered in person or

by mail. Acceptable forms of payment include personal or business checks, money orders, cashier’s

checks, certified checks, or electronic transfer. Grazing rentals not received by the due date will accrue a

lump-sum penalty of _____ % of the annual rental. Rental payments more than ten days late will accrue,

in addition, an interest penalty of _____ % (annualized) applicable from the first day of arrears.

Form 5-5516, Grazing Permit for Organized Tribes, Page 2 of 5

Permittee Initial _____

Animal Identification, Only livestock bearing the brands and marks herein shown may be grazed under

authority of this permit unless otherwise authorized by the Superintendent of the Agency, in writing, with a

pasturing authorization:

CATTLE BRANDS (R L) EAR MARK (R L) HORSE BRANDS (R L) SHEEP EAR MARK (R L)

WOOL MARK

PERMIT PROVISIONS AND CONDITIONS

Interpretation of Permit Provisions - The Superintendent will make decisions relative to the

interpretation of the terms of this permit and these Permit Provisions and Conditions. The terms of this

permit cannot be varied in any detail as herein provided without the written approval of the parties thereto

and any surety.

Payment of Rental - In consideration of the privileges granted by this permit the permittee

agrees to pay the grazing rental and all other applicable taxes and fees due annually according to 25

CFR 166.409-418, 166.500-504, and the provisions of this permit.

Bond and Insurance Requirement - An acceptable bond guaranteeing full performance of this

permit may be required pursuant to 25 CFR Subpart G.

Termination and Modification - It is understood and agreed that this permit may be modified or

terminated in whole or in part pursuant to 25 CFR 166.227-231 and 166.700-709. This permit is not

subject to renewal beyond the ending date indicated on the front of this document but may be extended

for up to one year by tribal resolution or in writing by the Agency Superintendent.

Assignment or Subletting - This permit may only be assigned, sublet, or mortgaged with the

written consent of the parties thereto, and the surety, if any.

Trust Lands Not Covered By Permit- It is understood and agreed by the permittee that he is

authorized to graze livestock on the lands covered by the permit as listed on the attached land description

and is responsible to prevent his livestock from grazing on lands not covered by this permit. Failure to

comply with this requirement may be cause for termination of the permit.

Entry by the BIA - BIA retains right of entry on lands covered by this permit at such reasonable

times as may be deemed necessary for inspection or enforcement.

Access to and Across Indian Lands - It is understood and agreed that authority is reserved to

the Superintendent to grant access to and across any of the lands covered by this permit as deemed in

the interest of the Indian landowner, including the privilege of prospecting for and removal of oil, gas, and

other minerals.

Indemnity -The permittee agrees to indemnify the United States and the Indian landowners

against all liabilities or costs relating to the use, handling, treatment, removal, storage, transportation, or

disposal of hazardous materials, or the release or discharge of any hazardous materials from the

permitted premises that occur during the contract term, regardless of fault.

Applicable Federal, State and Tribal Laws - The permittee must comply with all applicable

federal and state laws, rules, regulations, and other legal requirements. The permittee must also comply

with all applicable tribal laws, ordinances, resolutions and policies.

Permittee Obligation - While the lands covered by the permit are in trust or restricted status, all

of the permittee's obligations under the permit and the obligation of his sureties are to the United States

as well as to the owner of the land.

Authorized Uses -The permit authorizes the grazing of livestock only; the permittee shall not

utilize the permitted area for hay cutting, hunting, post or timber cutting, or any other non-grazing use

without written authorization from the responsible Indian or federal authority. The permittee is prohibited

from creating a nuisance, any illegal activity, or negligent use or waste of resources.

Adjustment of Grazing Capacity - The Agency Superintendent may adjust the grazing capacity

Form 5-5516, Grazing Permit for Organized Tribes, Page 3 of 5

Permittee Initial _____

and the season of use for the subject range unit pursuant to 25 CFR 166, Subpart D.

Affidavit of Permittee - The permittee may be required by the Superintendent to execute an

affidavit declaring the number of livestock by class and kind grazed under the permit.

Counting of Livestock - All livestock authorized to graze upon or trail over Indian land must be

made available for counting by the Superintendent. Arrangements should be made for counting all

livestock before entering the range unit. Permittees must notify the Superintendent a sufficient length of

time in advance so a representative can be present to count livestock on or off the range unit. The right is

reserved by the Bureau of Indian Affairs to have a representative present at each roundup to check the

number of stock. In the event the permittee fails or refuses to round up his stock at the proper times and

in a satisfactory manner for the purpose of allowing a count of the stock, the Superintendent shall have

the right to round up and count said stock at the expense of the permittee.

Livestock Exceeding Number Specified in Permit - If the number of livestock authorized under

the permit is exceeded, the excess livestock shall be considered to be grazing in trespass as defined at

25 CFR 166.800. The trespasser will be liable to pay the trespass damages, penalties and costs listed at

25 CFR 166.812 and will be considered in violation of the grazing permit. Excess livestock not promptly

removed from the range unit upon notice are subject to impoundment under the regulations at 25 CFR

166.806.

Distribution of Trespass Proceeds - Any funds collected by the BIA as trespass penalties or

damages to trust lands will be distributed pursuant to 25 CFR 166.818.

Failure to Make Full Use of the Permit - The permittee will not be allowed credit or rebate in

case the full number authorized is not grazed on the range unit.

Entering the Range - The earliest date upon which stock will be permitted to enter the range will

be the date shown in the permit. Notice must be given to the Superintendent prior to entering the range

unit. On reservations where permanent driveways have been established, all livestock will be required to

enter and leave the reservation on the particular driveway designated by the Superintendent. Except

where livestock are transported over or trailed over established rights-of-way, the route to be followed will

be designated by the Superintendent.

Movement of Livestock - The Superintendent reserves the right to direct the movement of

livestock whenever it is necessary for the protection and proper use of the range. The following acts are

prohibited:

(a) The grazing upon or driving across any trust Indian lands of any livestock without an

approved grazing or crossing permit.

(b) Allowing livestock to drift and graze on trust Indian lands without an approved permit.

of livestock.

(d) The grazing of livestock by a permittee upon an area of trust Indian lands withdrawn from

grazing use.

(e) Refusal to round up stock at proper times and in a satisfactory manner for the purpose of

allowing a count of the stock,

(f) Failure to remove livestock to prevent damage to the Indian lands upon receipt of instructions

from the Superintendent.

(g) Failure to comply with Conservation Plan provisions.

Range Improvements - The Bureau of Indian Affairs encourages the construction of

improvements necessary for proper management of livestock and the use of the range. Planned

improvements must be identified in the permittee’s Conservation Plan which will indicate whether the

improvement will:

(1) Remain on the land upon termination of the permit, in a condition that is in compliance with

applicable codes, to become the property of the Indian landowner; or

(2) Be removed and the land restored within a time period specified in the permit in which case the land

must be restored as close as possible to its condition prior to construction.

Written authorization must be given by the Superintendent prior to construction. The cost of such

improvements will be borne by the permittee unless otherwise provided for in the Conservation Plan. The

permittee shall perform reasonable maintenance of all range improvements identified in the Conservation

Plan in a manner acceptable to the Superintendent. The permittee may remove existing range

improvements identified on Form 5-5529, Removable Range Improvements Record, when the permittee

is responsible for all of the costs of the improvement and the Superintendent has approved the removal of

Form 5-5516, Grazing Permit for Organized Tribes, Page 4 of 5

Permittee Initial _____

the improvement.

Quarantine Regulations - All stock covered by this grazing permit are subject to the animal

welfare laws, quarantine laws and health regulations now in force or hereafter to be promulgated by the

United States, the state in which the reservation is situated, or by the tribal governing body.

Condition of Livestock Handling Facilities - Facilities used for livestock management must be

kept in a clean and sanitary condition. All rubbish and other refuse must be properly and promptly

removed.

Disposition of Carcasses - Animal carcasses shall be disposed of promptly and in accordance

with veterinary-recommended disposal methods taking into consideration cause of death and

environmental impacts. A carcass may not be buried on trust Indian land without prior written approval

from the Agency Superintendent.

Damage to Indian Land and Property - The permittee will be liable and will be required to repair

or make reimbursement for any damage done to the premises, livestock, or property of Indians resulting

from the acts of the permittee, his employees, or livestock.

Protection of Fish and Wildlife - The permittee must comply with federal and tribal fish, game,

and wildlife protection laws and regulations which apply to the reservation.

Conduct in Case of Fire - Whenever a permittee discovers an unauthorized and uncontrolled

fire, they shall report it to the nearest fire department as soon as possible. The unauthorized setting of a

fire or carelessness in connection with an authorized fire may result in criminal prosecution.

Filing of Permits - The Agency office contains public records of the United States pertaining to

trust Indian allotments. A copy of this permit will be filed in the Agency office and shall be available for

public inspection during normal business hours. A copy of this permit shall be recorded in the BIA Land

Titles and Records office which has jurisdiction. The permittee may file or record a copy of this permit, at

his own expense, in the appropriate county office.

ADDITIONAL PERMIT REQUIREMENTS AND PROVISIONS

Form 5-5516, Grazing Permit for Organized Tribes, Page 5 of 5

Permittee Initial _____

Attached to and made part of this permit are the Land Description and Conservation Plan.

Non-tribal lands within grazing unit: This permit is issued with the understanding that a grand total of

______ head of livestock will be grazed on the unit. This number includes ______, head of livestock that

reflect the grazing capacity of privately owned or leased lands within the unit to be grazed in common with

permitted tribal lands by the permittee. The right to the use of these lands (e.g., a current lease) must be

recorded with the Agency Superintendent and a full description attached hereto and made part of the

permit.

This permit shall be of no force or effect until signed and sealed by the authorized tribal officer(s) and

approved by the Agency Superintendent.

Issued at the _______________________________ this ______ day of __________, _______.

(Agency or Tribal Office) (Month, Year)

Tribal Official ___________________________________________

Title ___________________________________________

I accept this permit and the Provisions and Conditions contained herein.

Permittee _____________________________ ___/___/______

Witness _____________________________ ___/___/______

Approved

Superintendent _____________________________ ___/___/______

Paperwork Reduction Act Statement: This form is covered by the Paperwork Reduction Act. It is used to establish the respective

rights and responsibilities of the respondent and the Federal government. The information is provided by respondents to obtain or

retain a benefit. In compliance with the Paperwork Reduction Act of 1995, as amended, the collection has been reviewed by the

Office of Management and Budget and assigned a number and an expiration date. The number and expiration date are at the top

right corner of the form. An agency may not sponsor or conduct, and a person is not required to respond to, a request for

information collection unless it displays a currently valid OMB Control Number. The public reporting burden is estimated to average

20 minutes per respondent. This includes the time needed to understand the requirements, gather the information, complete the

form, and submit it to the Department. Comments regarding the burden or other aspects of the form may be directed to the Indian

Affairs Information Collection Clearance Officer, Office of Regulatory Affairs – Indian Affairs, 1849 C Street, NW, MS-4141,

Washington, DC 20240.

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