Form 5460-17 Substitution Determination

Print

Reset
FORM APPROVED

Form 5460-17
(March 2007)

OMB No. 1004-0058
Expires: February 28, 2010

UNITED STATES
DEPARTMENT OF THE INTERIOR
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,
regard to timber from lands tributary* to the above processing facility:

I

We hereby submit the following information with

1. Historical Base Determination:
(MBF)

a. State volume of last export sale.
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 in

(MBF)

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 twelve (12)

(MBF)

months from date in lb, above. (Include volume of last export sale.)
b. State 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)

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:
SCALING METHODS

SCALED BY
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)

Comments (continued)

(Continued on Page 3)

(Form 5460-17, page 2)

NOTICES

The Privacy Act of 1974 and the regulations in 43 CFR 2.48(d) provide that you can be furnished with the following information required

by this application.

AUTHORITY: 43 CFR part 5420.

PRINCIPAL PURPOSE: BLM uses this information to determine the volume of timber exported during the last 12 months.

ROUTINE USES: BLM will disclose the information on this form pursuant to the regulations in 43 CFR 2.56.

EFFECT OF NOT PROVIDING INFORMATION: Disclosure of the information is required to process the application. If all the

information is not provided, the application may be rejected.

The Paperwork Reduction Act of 1995 requires us to inform you that:

The BLM collects this information to determine the volume of timber that you have exported during the last 12 months.

The 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.

The 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.

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, N.W., Mail Stop 401 LS, Washington, D.C. 20240.

(Form 5460-17, page 3)