Form DI Form 1926 DI Form 1926 Application for Permit for Archeological Investigations

DI Form 1926 (Rev Sept 2004)
OMB No. 1024-0037
Exp. Date: XX/XX/XXXX

FOR OFFICIAL USE ONLY
Date Received ____________
Sent for Review____________
Control No. _______________

United States Department of the Interior
Application for Permit for Archeological Investigations
Under the Authority of
The Archaeological Resources Protection Act of 1979
(16 U.S.C. 470aa-mm; 43 CFR 7);

and/or The Antiquities Act of 1906

(P.L. 59-209; 34 Stat. 225; 16 U.S.C. 431-433; 43 CFR 3)

and/or the appropriate Bureau-specific statute Such as
The Reclamation Act; The National Park Service Organic Act; The National Wildlife
Refuge System Administration Act; The Federal Land Policy and Management Act
Instructions: Complete and return two copies of this application form and required attachments to the appropriate State or
Regional Office of the land managing bureau involved. All information requested must be completed before the application
will be considered. Use separate pages if more space is needed to complete a section.
1. Name of applicant (institution, corporation, partnership, individual, or other entity)

2. Mailing address

3. Telephone number(s)

4. Email address(es)

5. Nature of archeological work proposed

□ Survey and Recordation
□ Limited Testing and/or Collection (project-specific)
□ Excavation and/or Removal (project-specific)
7. Time of proposed work
Overall duration of project:
Estimated duration of fieldwork:

6. Location of proposed work (attach additional sheets)
a. Description of Federal lands involved. Indicate State, county, and Federal
administrative unit. Specify the best available location data, e.g., GPS
coordinates, UTM coordinates, township, range and section (cadastral)
subdivisions, or metes and bounds. Include a readable copy of a map or plan
at an appropriate scale showing specific areas for which permit is desired.
b. Identification of archeological resource(s) or other cultural resource(s)
involved (if applicable).

From

To

From

To

8. Principal Investigator
Name of individual(s) responsible for planning and generally overseeing field
projects, including overall supervision of staff and overall responsibility for the
professional quality of resource evaluations and recommendations.

Principal Investigator contact information
Telephone number(s):

Email address(es):

DI Form 1926 (Rev Sept 2004) Page 2

9. Field Director
Name of individual(s) responsible for carrying out field projects, for technical
quality of fieldwork through direct on-the-ground supervision of all aspects of
fieldwork and data gathering, for proposing resource evaluations and
recommendations for further treatment, and for preparing field records and
descriptive reports.

10. Permit Administrator
Name of individual responsible for fulfilling the terms and conditions of the permit
(must be legally empowered to obligate applicant organization).

Field Director contact information
Telephone number(s):

Email address(es):

Permit Administrator contact information
Telephone number(s):

Email address(es):

11. Applicant must include the following attached to the application form.
a. Description of the purpose, nature, and extent of the work proposed, including how and why it is proposed to be conducted: (include research
design, methods, curation);
b.

Summary of organizational capabilities, including information on location(s) and description of facilities and equipment, on organizational
structure and staffing, and on facilities, equipment and staff to be involved in the proposed work;

c.

Summary of organizational history in completing work of the kind proposed, including similar past projects, government contracts, and
Federal permits (previously held, currently in force with effective dates, and currently pending or planned, by agency and region/state), reports
and/or publications resulting from similar work, and any other pertinent organizational experience;

d.

For each individual named in 8 and 9 above, a curriculum vitae or similar resume or summary of education, training, and experience in the
kind of work proposed and in the role proposed;

e.

Written certification, signed by a properly authorized official of the proposed curatorial facility, attesting to the facility’s capability and
willingness to accept any collections, as applicable, and records, data, photographs, and other documents generated during the proposed term
of the permit, and to assume permanent curatorial responsibility for such materials on behalf of the United States Government pursuant to 36
CFR 79. In the case of an application on Indian lands where the Indian Tribe or Indian owner(s) do not wish to take custody, written consent
to undertake curation is required from the Indian Tribe or the Indian owner(s) pursuant to 25 CFR 262.8. Custody of any Native American
human remains or cultural items subject to the Native American Graves Protection and Repatriation Act (NAGPRA), 25 USC 3001-3013,
removed from public lands or Indian lands shall be determined in accordance with NAGPRA and its implementing regulations, 43 CFR 10.

12. Proposed outlet(s) for public written dissemination of the results

13. Signature of individual named in 10

14. Date signed

Paperwork Reduction Act and Estimated Burden Statement: This information is being collected pursuant to 16 U.S.C. 470cc and 470mm, to provide
the necessary facts to enable the Federal land manager (1) to evaluate the applicant’s professional qualifications and organizational capability to conduct
the proposed archeological work; (2) to determine whether the proposed work would be in the public interest; (3) to verify the adequacy of arrangements
for permanent curatorial preservation, as United States property, of specimens and records resulting from the proposed work; (4) to ensure that the
proposed activities would not be inconsistent with any management plan applicable to the public lands involved; (5) to provide the necessary information
needed to complete the Secretary's Report to Congress on Federal Archeology Programs; and (6) to allow the National Park Service to evaluate Federal
archeological protection programs and assess compliance with the Archaeological Resources Protection Act of 1979 (16 U.S.C. 470). Submission of the
information is required before the applicant may enjoy the benefit of using publicly owned archeological resources. To conduct such activities without a
permit is punishable by felony-level criminal penalties, civil penalties, and forfeiture of property. A federal agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it displays a valid OMB control number. Public reporting for this collection of
information is estimated to average 2.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any
other aspect of this collection of information, including suggestions for reducing this burden, to the Departmental Consulting Archeologist; NPS; 1849
C Street, NW (2275); Washington, DC 20240-0001.