Designation of Excess Land

FORM 7-21XSINAQ
2012 Instructions
(7-11)

ATTACHMENT SHEET FOR FORM 7-21XS
(IDENTIFICATION OF INVOLUNTARILY ACQUIRED EXCESS LAND)
[Required Information for Item 11(d) of Form 7-21XS]
For Certification and Reporting Requirements of the
Reclamation Reform Act of 1982

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 30 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 Reclamation Reform Act of
1982 (RRA) forms. 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. Also
refer to the separate instructions for the “Designation of Excess
Land” (Form 7-21XS), to which this form is an attachment.
While the information requested by this attachment sheet is
required, you may use this attachment sheet or your own similar
attachment sheet to provide the required information.
INFORMATION ABOUT THIS FORM
This Form 7-21XSINAQ (or your own similar attachment) must
be completed and attached to Form 7-21XS if you involuntarily
acquired eligible land and designated that land as excess. Please
refer to the separate instructions for the “Designation of Excess
Land” (Form 7-21XS) for further information about designating
excess land and the RRA forms requirements for excess land.
GENERAL INSTRUCTIONS
Type or print in ink all answers. You must initial and date any
crossouts and corrections. Please contact your district office or
the appropriate Reclamation office if you have any questions.
ITEM BY ITEM INSTRUCTIONS
If you involuntarily acquire nonexcess land and designate it as
excess, in general, the land will be eligible to receive
Reclamation irrigation water for 5 years from the date of
acquisition, or in the case of inheritance, from the date of the
previous landholder’s death.

(1) Identify which nonexcess land parcel you involuntarily
acquired and designated as excess in item 11 of
Form 7-21XS by providing the legal description of the
land parcel or an assessor’s parcel number.
(2) Enter the name of the landholder from whom each
parcel was involuntarily acquired.
(3) Enter the date each parcel was involuntarily acquired.
(4) Enter the status of the parcel when it was acquired
(e.g., nonexcess or excess; subject to a deed covenant
requiring our sales price approval for 10 years, etc.).
(5) If the land was excess when it was involuntarily
acquired, identify why is the land eligible to receive
Reclamation irrigation water (e.g., placed under
recordable contract, nonexcess land involuntarily
acquired and designated excess by the previous
landholder, etc.).
(6) Enter the acreage limitation status of the landholder
from whom the land was involuntarily acquired
(i.e., subject to the discretionary provisions or
prior law).
(7) Enter the water rate applicable for Reclamation
irrigation water delivered to the previous landholder
(i.e., contract rate, full operation and maintenance rate,
or full-cost rate).