Certification of Religious or Charitable Organization's Landholdings

FORM 7-2184
2012 Instructions
(7-11)

INSTRUCTIONS FOR CERTIFICATION OF
RELIGIOUS OR CHARITABLE ORGANIZATION’S
LANDHOLDINGS
(Discretionary Provisions)

Bureau of Reclamation
Do not use this form after December 31, 2012

OMB Control No.: 1006-0005

Paperwork Reduction Act
This information is being collected to establish landholder compliance with Federal reclamation law. Response to this request is mandatory in
accordance with Public Law 97-293 and 43 CFR 426.18. Public reporting burden for this form is estimated to average 45 minutes per response,
including time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. An agency may not conduct
or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid Office of Management and
Budget (OMB) control number. Direct comments regarding the burden estimated or any other aspect of these forms to Manager, Land
Resources Office, Code 84-53000, Bureau of Reclamation, PO Box 25007, Denver CO 80225.

GENERAL INFORMATION
“General Information About RRA Forms” (Form 7-21INFO)
provides basic instructions on using the Reclamation Reform Act
of 1982 (RRA) forms. Ask your district office for this form each
year to keep current. Refer to the definitions at the end of
Form 7-21INFO whenever the meaning of a term is not clear to
you. Please note, some terms such as “irrigable land,”
“irrigation land,” and “irrigation water” have special definitions
when used in these forms which differ from their common
meaning. Other terms and corresponding definitions that are
specific to the RRA forms are:
•

“Land” or “acres” means irrigable or irrigation land.

•

“Organization” means a religious or charitable
organization.

•

“You” means the officer or authorized agent of the
organization who completes this form for the organization.

•

“We,” “us,” “our,” or “Reclamation” means the Bureau of
Reclamation.

Visit www.usbr.gov/rra for more information.

(1) Your organization is exempt from paying Federal
income taxes under section 501 of the Internal Revenue
Code of 1954, as amended;
(2) Your organization’s or subdivision’s agricultural
produce and proceeds from the sales of such produce
are used only for charitable purposes;
(3) Your organization or subdivision, itself, operates the
land; and
(4) No part of the net earnings of your organization or
subdivision accrues to the benefit of any private
shareholder or individual.
This is not the appropriate form for your organization to submit
if it does not meet all of these criteria, and you should contact
your district office for guidance. Please contact each district in
which your organization holds land to find out each district’s
forms submittal category since a district’s RRA forms submittal
category is subject to change annually.
OPTIONS FOR SUBMITTING THIS FORM
The organization that must submit a Form 7-2184 must choose
one of the following options:

WHO MUST SUBMIT THIS FORM
Your organization must certify its landholdings on a
“Certification of Religious or Charitable Organization’s
Landholdings” (Form 7-2184) if the part of the organization
responsible for RRA form submission is subject to the
discretionary provisions of the RRA, the westwide landholdings
of the part of the organization responsible for RRA form
submission and any subdivisions to be included on the form total
more than 240 acres in a Category 1 district, or more than
80 acres in a Category 2 district, AND if:

(1) Each division or subdivision of the organization may
submit a certification form certifying just that division's
(subdivision's) landholdings. Under this option, only
the acres held by the division (subdivision) submitting
this form will be considered in determining whether the
applicable RRA forms submittal threshold has been
exceeded. Divisions (subdivisions) may need to
coordinate with each other to determine exactly what
land parcels each division (subdivision) will include on
their respective RRA forms so the same land parcel
doesn't appear on multiple RRA forms. Item 5(b),
which requests information on subdivisions, must be

For more information on landholding changes, see Fact Sheet 11
which is available at your district office.

left blank because under this option, each division
(subdivision) submits its own Form 7-2184.

ANNUAL CERTIFICATION

OR

Your organization must submit Form 7-2184 each and every
year prior to the delivery of Reclamation irrigation water if its
westwide landholdings exceed the applicable RRA forms
submittal threshold, with the following exceptions:

(2) A part of the organization may submit a certification
form certifying both its landholdings and the
landholdings of one or more of its subdivisions. Under
this option, the acres held by the organization and the
acres held by the subdivision(s) included on the form
will both be considered in determining whether the
applicable RRA forms submittal threshold has been
exceeded. Item 5(b), which requests information on
subdivisions, must list the subdivision(s) that hold land
included on this form. If you list any subdivisions in
item 5(b), those subdivisions must be considered when
reference is made to your organization for the
remainder of this form.

(1) Your organization may submit a “Verification of
Landholdings” (Form 7-21VERIFY) instead of Form
7-2184 if your organization's westwide landholdings
have not changed since the last Form 7-2184 was
submitted.
(2) Your organization may submit a Form 7-21VERIFY
together with a new “Selection of Full-Cost Land”
(Form 7-21FC) if its westwide landholdings have not
changed since the last Form 7-2184 was submitted,
and your organization wants to reselect its full-cost
land.

Please contact your district office or the appropriate Reclamation
office if you have any questions regarding these options.
WHERE TO SUBMIT FORMS

(3) Your organization does not need to submit any RRA
forms if:

Your organization must submit a certification form to
each district in which the organization holds (directly or
indirectly owns or leases) land. You must submit the original
form to one district office and may submit copies to the others if
your organization holds land in more than one district.

•

It only holds land indirectly through entities, trusts,
or estates;

•

Neither the acres attributed to your organization
nor the percentage of the entity, trust, or estate
attributed to your organization has changed since
the last Form 7-2184 was submitted; and

•

All other information on your organization’s
previously submitted Form 7-2184 has not
changed.

WHAT LAND TO INCLUDE
The part of the organization submitting this form must certify all
of its land held westwide that is subject to the acreage limitation
provisions. Land subject to the acreage limitation provisions that
is held westwide by any subdivisions listed on this form must
also be certified on this form. Please see Form 7-21INFO if your
organization has excess land or full-cost land to identify. Your
organization must provide an accurate legal description or an
assessor’s parcel number for each land parcel. Be sure to break
down land parcels as far as necessary to ensure accurate
identification.

IRREVOCABLE ELECTION
Please be aware, by submitting this form, a prior law recipient
that only holds land indirectly in a district that has conformed to
the discretionary provisions will be making an irrevocable
election to conform to the discretionary provisions. That action
will be binding in that and all other districts in which the
landholder holds land subject to the acreage limitation
provisions.

IF LANDHOLDINGS CHANGE
You must notify all districts in which your organization holds
land within 30 calendar days if your organization's westwide
landholdings change during the water year, and you must submit
new certification forms within 60 calendar days of the change.
These 30- and 60-day grace periods do not apply to a new
landholder. A new landholder must submit certification forms
prior to receiving Reclamation irrigation water. Any change
that affects the four criteria listed under “Who Must Submit This
Form” is considered to be a landholding change.

See Form 7-21INFO for more information on how an
irrevocable election impacts your organization's westwide
acreage limitation status.

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FORM 7-2184 (2012)

GENERAL INSTRUCTIONS

reference is made to your organization for the
remainder of this form.

You must type or print in ink all answers. You must initial and
date any crossouts and corrections. You may attach continuation
sheets to list information. Preprinted continuation sheets are
available for this purpose, or you may make your own. District
name abbreviation(s) used on this form must be spelled out on
the form where the abbreviation is used for the first time, or on a
separate sheet attached to this form. Please contact your district
office or the appropriate Reclamation office if you have any
questions.

6.

List other names through which your organization or any
subdivision listed in item 5(b) holds 100-percent interest in
land.

7.

Is your organization exempt under Section 501 of the
Internal Revenue Code? Please contact the appropriate
Reclamation office for guidance before completing the rest
of this form if you answer “no” to this question or upon
request you cannot provide proof of your organization’s tax
exempt status.

8.

Answer the questions listed for both the part of the
organization submitting this form and for any subdivisions
listed in item 5(b). These questions relate to your
organization's entitlement. Immediately contact the
appropriate Reclamation office for further guidance before
completing the remainder of this form if you answer “yes” to
any of these questions.

9.

Check the box next to the one statement that best describes
how your organization became subject to the discretionary
provisions. Provide the requested information for that
statement. Please contact your district office if you do not
know which statement applies to your organization.

ITEM BY ITEM INSTRUCTIONS
Organization Information
1.

Enter your organization’s complete name.

2.

(a) Enter the local street address or rural route number,
city, state, and ZIP code of your organization. An
attorney's address, “c/o” address, etc., is not acceptable
in place of a street address. Post office box numbers
may be used only if no other address exists.
(b) Enter your organization's mailing address if it is
different from the street address.

3.

(a) Enter the telephone number where questions can be
directed.

Land Your Organization Directly Owns

(b) Enter the name of a contact person at that telephone
number.
4.

It is the responsibility of landowners, sellers of land, and districts
to notify lessees, buyers of land, and new landholders,
respectively, of the RRA forms submittal requirements
associated with the land in question.

(a) Enter the state(s) or country (ies) in which your
organization is established or registered. Your
organization will be required to submit documentation
verifying the country (ies) in which your organization is
established when your organization irrevocably elects
to conform to the discretionary provisions if it indicates
a country other than the United States.

10. Enter your organization's name again. (These forms
are often photocopied, so it is necessary to have your
organization identified on each page.)
11. This section requests information regarding land westwide
that your organization directly owns. The information must
include land directly owned by any subdivisions listed in
item 5(b). Also include land leased from a public entity
here instead of including it as leased land in item 14 because
it counts against the lessee's ownership entitlement
(pursuant to Public Law 91-310). In that situation, write the
land is leased from a public entity and include the name of
that public entity after the legal description of the land
parcel. Enter the following for each land parcel:

(b) Enter your organization’s Employer Identification
Number (EIN). You must obtain an EIN for this form
if your organization does not have one. The Internal
Revenue Service (IRS) requires all non-profit
organizations to have an EIN.
5.

(a) Enter the complete name of the central organization (if any)
with which your organization is affiliated.
(b) Enter the name(s) of any subdivisions of this
organization with landholdings that are being certified
on this form. For additional space, use attachments.
Any subdivisions listed here must be considered when

(a) Name of district in which the land parcel is located.
Group land parcels by district to make it easier for you
to complete items 21 through 27.

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FORM 7-2184 (2012)

13. Enter your organization’s name.

(b) Provide an accurate legal description of the land parcel
or an assessor’s parcel number. For each land parcel
that is directly owned by any subdivision listed in item
5(b), include the name of that subdivision. For each
lessee, sublessee, or operator entered in item 11(d) [or
for your organization if you check “self” in item 11(c)],
there is space to list six land parcels (one parcel per
line) if all parcels are operated by the same natural
person or entity in the same district. You may list more
than one parcel per line if all parcels have the same
lease information.

14. This section requests information regarding land westwide
that your organization leases from another party. The
information must include land directly leased by any
subdivisions listed in item 5(b). Do not include land leased
from a public entity here; instead, include it in item 11.
Include information regarding any land your organization
and any subdivisions listed in item 5(b) sublease to others
here. Enter the following for each land parcel:
(a) Name of district in which the land parcel is located.
Group land parcels by district to make it easier to
complete items 21 through 27.

(c) Who primarily operates the land parcel: your
organization (self); a lessee or sublessee under a lease
(lessee/sublessee); or an operator under any other type
of farm operating arrangement (other).
(d) Name, address, and telephone number of each lessee,
sublessee, or other type of operator. Check the
appropriate box to indicate why your organization is
identifying a lessee, sublessee, or other operator. Skip
this column and go to item 11(g) if your organization
primarily operates the land parcel.

(b) Provide an accurate legal description of the land parcel
or an assessor’s parcel number. For each land parcel
that is directly leased by any subdivision listed in
item 5(b), include the name of that subdivision.
(c) Who primarily operates the land parcel: your
organization (self) or another party (other). If another
party operates your land, indicate in column (d) if the
land is not receiving Reclamation irrigation water or if
the land was involuntarily acquired.

(e) Starting date of the lease. This is the date the lease first
became effective. Enter the date the lease was signed if
no effective date was specified in the lease. Remember,
leases cannot exceed 10 years except with our approval
for perennial crops, which are determined on a crop-bycrop basis but cannot exceed 25 years.

(d) Natural person or entity that directly owns the land your
organization leases. Enter the sublessee’s name as well
as the landowner’s name if your organization subleases
the land to another landholder. If your organization
subleases the land from another landholder, enter the
sublessor’s name and the landowner’s name. Include
the farm operator’s name if the land is operated by a
farm operator.

(f) Ending date of the lease. This is the date on which the
current lease will terminate, including all exercisable
options.
(g) Number of acres in the land parcel. If your
organization leases land from a public entity and then
subleases it to another landholder, do not list those
acres in this column because they are attributed to the
sublessee.

(e) Starting date of the lease. This is the date the lease first
became effective. Enter the date the lease was signed if
no effective date was specified in the lease. Remember,
leases cannot exceed 10 years except with our approval
for perennial crops, which are determined on a crop-bycrop basis but cannot exceed 25 years.

12. Total column 11(g). This is the number of acres your
organization directly owns westwide. Include in this total
any directly owned acres listed on continuation sheets or
attachments.

(f) Ending date of the lease. This is the date on which the
current lease will terminate, including all exercisable
options.

Land Your Organization Directly Leases From
Another Party

(g) Number of acres in the land parcel. Do not list acres
that your organization subleases to others in this
column because they are attributed to the sublessee.

Landholders that lease land to or from other landholders should
inform the lessees and lessors of their obligation to also submit
RRA forms. If either the lessee or lessor fails to submit
RRA forms, the eligibility of the land to receive Reclamation
irrigation water will be jeopardized.

15. Total column 14(g). This is the total number of acres your
organization directly leases (and subleases) westwide.
Include in this total any directly leased (and subleased) acres
listed on continuation sheets or attachments. Please contact
4

FORM 7-2184 (2012)

completing this item you will prevent counting the
same land twice against your organization's entitlement,
once as directly owned land and again as indirectly
leased land if this situation applies to your organization.

your district office for further instructions if all or part of
your organization’s directly leased land is also attributable
to your organization’s indirectly owned land.
Land Your Organization Indirectly Owns or Leases
Through Other Entities

(1) Enter the number of acres from item 16(g) that
your organization directly owns and leases to the
entity, trust, or estate.

16. This section requests information regarding land that your
organization indirectly owns or leases westwide through
other entities, trusts, or estates. The information must
include land indirectly owned by any subdivisions listed in
item 5(b). Obtain a completed copy of any entity’s
“Certification of Entity’s Landholdings” (Form 7-2181) or
“Report of Entity’s Landholdings” (Form 7-2191), or any
trust’s or estate’s “Declaration of Trust’s or Estate’s
Landholdings” (Form 7-21TRUST) that attributes land to
your organization. By referring to the information contained
on the entity's, trust's, or estate's form, you can help ensure
that the information you certify on your form is accurate.
Enter the following for each land parcel in each district in
which the entity, trust, or estate holds land attributed to your
organization:

(2) Subtract item 16(h)(1) from item 16(g). This is
the number of adjusted acres that the entity, trust,
or estate leases to use in calculating the number of
leased acres attributed to your organization.
If this double-counting adjustment does not meet your
organization’s particular scenario, please contact your
district office.
(i) Multiply item (16)(d) (in decimal form) by
item 16(h)(2) if you completed item 16(h). Multiply
item 16(d) (in decimal form) by item 16(g) if you did
not complete item 16(h). This is the number of leased
acres attributable to your organization through the
entity, trust, or estate.

(a) Name of district in which the land parcel is located.
Group land parcels by district to make it easier to
complete items 21 through 27.

17. Total column 16(f). This is the total number of acres your
organization indirectly owns westwide. Include in this total
any indirectly owned acres listed on continuation sheets or
attachments.

(b) Name of the entity, trust, or estate that holds land in
which your organization owns an interest or is a
beneficiary.

18. Total column 16(i). This is the total number of acres your
organization indirectly leases westwide. Include in this total
any indirectly leased acres listed on continuation sheets or
attachments.

(c) The entity's, trust's, or estate's EIN. Leave this blank if
the entity, trust, or estate does not have an EIN and is
not required by the IRS to have an EIN.
(d) Percentage of interest your organization owns in each
entity or the percentage of land in a trust or estate
attributed to your organization.

Landholdings Summary

(e) Total number of acres owned (directly and indirectly)
by the entity, trust, or estate.

20. Enter the name of each district in which your organization
holds land westwide. Circle the district at which the
original form is filed if your organization is a multidistrict
landholder.

19.

(f) Multiply item 16(d) (in decimal form) by item 16(e).
This is the number of acres that your organization
indirectly owns through the entity, trust, or estate.

Enter your organization’s name.

21. For each district, enter the total number of acres your
organization directly owns in the district. Obtain this
information from item 11(g). Add the number of acres in
item 21 and enter that number in the “TOTAL” column
(far right column). This is the number of acres your
organization directly owns westwide and should equal
item 12.

(g) Total number of acres leased (directly and indirectly)
by the entity, trust, or estate.
(h) This item applies if your organization directly owns
land and leases that same land to an entity, trust, or
estate in which your organization owns an interest.
Leave both sections of item 16(h) blank if your
organization does not have this situation. By
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FORM 7-2184 (2012)

26. For each district, add item 24 and item 25. This is the total
number of acres your organization leases in each district.
Add the number of acres in item 26 and enter that number in
the “TOTAL” column (far right column). This is your
organization's leased acres westwide.

22. For each district, enter the total number of acres your
organization indirectly owns in the district. Obtain this
information from item 16(f). Add the number of acres in
item 22 and enter that number in the “TOTAL” column
(far right column). This is the number of acres your
organization indirectly owns westwide and should equal
item 17.

27. For each district, add item 23 and item 26. This is the total
number of acres your organization holds in each district.
Add the number of acres in item 27 and enter that number in
the “TOTAL” column (far right column). This is the
number of acres your organization holds westwide and
counts against your organization’s nonfull-cost entitlement.
Your organization must also submit a Form 7-21FC if this
number is more than your organization’s nonfull-cost
entitlement AND your organization directly or indirectly
leases land.

23. For each district, add item 21 and item 22. This is the total
number of acres your organization owns in each district.
Add the number of acres in item 23 and enter that number in
the “TOTAL” column (far right column). This is the
number of acres your organization owns westwide and
counts against your organization’s ownership entitlement.
Your organization must submit a “Designation of Excess
Land” (Form 7-21XS) if this number is more than your
organization's ownership entitlement.

Signatures
We will determine all land held by your organization to be
ineligible to receive Reclamation irrigation water until the
appropriate excess designation is made if your organization
exceeds its westwide ownership entitlement and it does not
submit Form 7-21XS to designate its excess acres.
Regardless of whether your organization’s owned land
exceeds it ownership entitlement, you must complete a
Form 7-21XS and designate land as excess on that form if
your organization:
•

Purchases land that was designated as excess by the
seller without our sales price approval;

•

Involuntarily acquires excess land; or

•

Involuntarily acquires eligible land and designates it as
excess.

28. Read the attestation statements carefully and sign and date
the form in ink. An officer or authorized agent from the part
of the organization that is submitting this form must sign it.
The statements concerning the reporting of changes in
information, the rent paid on irrigation land, written leases,
and the terms of such leases are requirements of Federal
reclamation law.

24. For each district, enter the total number of acres your
organization directly leases in the district. Obtain this
information from item 14(g). Add the number of acres in
item 24 and enter that number in the “TOTAL” column
(far right column). This is the number of acres your
organization directly leases westwide and should equal
item 15.
25. For each district, enter the total number of acres your
organization indirectly leases in the district. Obtain this
information from item 16(i). Add the number of acres in
item 25 and enter that number in the “TOTAL” column
(far right column). This is the number of acres your
organization indirectly leases westwide and should equal
item 18.

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FORM 7-2184 (2012)