Form 5460-17 Substitution Determination

Form 5460-17
(March 2004)

FORM APPROVED

OMB No. 1004-0058 Expires: January 31, 2007

UNITED STATES
DEPARTMENT O F THE INTERIOR
BUREAU O F L A N D MANAGEMENT

Purchaser or Affiliate

SUBSTITUTION

Location of Processing Facility

Contract Number

DETERMINATION

In compliance with requirements of 43 Code of Federal Regulations 5424.1,
timber from lands tributary* to the above processing facility:

I

We hereby submit the following information with regard to

1. Historical Base Determination:
a. State volume of last export sale.

(MBF)

b. State date of last export sale.
c. State total volume of exported private timber in preceding twelve

(MBF)

(12) months from date in b, above. (Exclude volume of last export

sale.)
d. State total volume of Federal timber purchased or otherwise acquired

(MBF)

in preceding twelve (12) months from date in b, above.
2. Timber Transactions Since Historical Base Period:
a. State total volume of private timber exported in succeeding

(MBF)

twelve (12) months from date in lb, above. (Include volume of last

export sale.)
b. State total volume of Federal timber purchased or otherwise acquired

(MBF)

in 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)

c.

MBF exported timber after base period (same as 2a, above)

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)
months from date of last export sale. Report volumes of timber in
(MBF). Do not include exempted species.

Specify type of rule used, long log or short log. If volume was sold on
a scale basis, state scaling method.

*Tributary lands mean area from which timber is expected to be delivered to a given processing facility.

(See statement on page 2)

NOTICE
The Paperwork Reduction Act of 1995 requires us to inform you that:
This information is collected to determine the volume of timber that you have exported during the last 12
months.
BLM uses the information to determine whether or not you have complied with the terms of your contract.
Response to this request is mandatory under the terms of your timber contract.
BLM would like you to know that you do not have to respond to this or any other Federal agencysponsored information collection unless it displays a currently valid OMB control number.

BURDEN HOURS STATEMENT
Public reporting burden for this form is estimated to average one 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 U.S. Department of the
Interior, Bureau of Land Management, (1004-0058), Bureau Information Collection Clearance Officer,
(WO-630), 1849 C Street, Mail Stop 401 LS, N.W., Washington, D.C. 20240.
Comments (continued)

(Form 5460-17, page 2)