Form 7-21PE-IND Attachment Sheet for Form 7-21PE

OMB CONTROL NO.: 1006-0005

FORM 7-21PE-IND
2012

ATTACHMENT SHEET FOR FORM 7-21PE
(IDENTIFICATION OF INDIRECTLY HELD LAND)
(Required Information for Form 7-21PE Regarding Public Entities With Indirect Landholdings)
For Certification and Reporting Requirements of the Reclamation Reform Act of 1982

(7-11)
BUREAU OF RECLAMATION

Do not use this form after December 31, 2012. It is important that you refer to the instructions on the reverse side of this form before completing it. For additional space use your own similar attachment sheet.
Type or print in ink. Date and initial crossouts and corrections. Visit www.usbr.gov/rra for more information.

1.
2.

PUBLIC ENTITY NAME:
LAND THE PUBLIC ENTITY INDIRECTLY OWNS OR LEASES THROUGH WHOLLY OWNED LEGAL ENTITIES
(b)
Wholly Owned
Legal Entity's
EIN

(a)
Name of Wholly Owned
Legal Entity

3.

(c)
Legal Description of Land Parcel(s) or
Assessor's Parcel Number(s)

(d)
Number of
Acres

LAND THE PUBLIC ENTITY INDIRECTLY OWNS OR LEASES THROUGH PARTIALLY OWNED LEGAL ENTITIES

(a)
Name of Partially Owned
Legal Entity

(b)
Partially Owned
Legal Entity's
EIN

(c)
State or Country
Where Partially
Owned Legal Entity
is
Established

(d)
Legal Description of Land Parcel(s) or
Assessor's Parcel Number(s)

(e)
Percentage
of Public
Entity's
Ownership in
the Partially
Owned Legal
Entity

(f)
Number of
Acres
Owned and
Leased by
the Partially
Owned
Legal Entity

(g)
Acreage
Attributable to the
Public Entity
Through It's
Interest in the
Partially Owned
Legal Entity
(e X f)