Form 7-2537 Trust Information Sheet

7-2537 (07-11)
Bureau of Reclamation

OMB Control No.: 1006-0023
OMB Expiration Date: December 31, 2013

TRUST INFORMATION SHEET
(To be completed by the trustee of only those trusts that hold 40 acres or less westwide.)
[Use of this Sheet is to be initiated by Reclamation only.]
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
5 minutes per response. 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.

For Reclamation Use Only
District name(s):

Date Requested:

Trust name:

1. Trust name:
Note: This form is to be completed by trusts. If you are completing this form for some other type of entity, STOP and contact the
appropriate Reclamation office for additional instructions.

2. Date trust was established:
3. Trust's Employer Identification Number (EIN):
(An EIN must be provided if your trust is required by the
Internal Revenue Service to have an EIN.)

4. Name of state or country where trust is established or registered:
5. Number of acres held (directly or indirectly owned or leased) by the trust in this district:
6. Does this trust hold land in any other district(s)?
YES
NO
If “YES,” list the district(s) and the number of acres held by the trust in the district(s).
District Name

Acres Held

7. Legal description or assessor’s parcel number of the land(s) held in trust:

8. Names of CURRENT beneficiaries (those that are currently entitled to receive benefits from the trust) and
interest held by each (attach additional sheet if necessary):
Name

Percentage of Interest

See other side for instructions.

Trustee Copy

Page 1 of 2

7-2537 (07-11)
Bureau of Reclamation

OMB Control No.: 1006-0023
OMB Expiration Date: December 31, 2013

9. Name(s) of current trustee(s):

10. Name(s) of grantor(s)/creator(s):

11. Please answer the following questions:
YES

NO

NOT
SURE

Is the trust in writing?
Are the current beneficiaries identified within the trust document?
Are the interests of the current beneficiaries identified within the trust document?
Is the trust revocable?
If revocable, does the trust specify to whom title to the land will be held upon revocation?
Are any of the beneficiaries 18 years of age or younger and subject to the discretionary provisions?
Does the land held in trust, when combined with other holdings, exceed the ownership or nonfull-cost
entitlements of the (1) beneficiaries, (2) grantor, or (3) parents or guardians of any beneficiary who is 18 years
of age or younger and subject to the discretionary provisions?
Do the trust landholdings include acquisition or disposition of land subject to Secretarial price approval
(i.e., excess land)?
Is the land held in trust for the benefit of entities that are limited recipients or prior law entities benefitting more
than 25 natural persons?

Please attest to the following:
I (we) attest that the information provided herein is true, accurate, and complete to the best of my (our) knowledge. Based
on the information provided on this sheet, Reclamation may request additional information including the entire trust
document for review.
Signature(s) of trustee(s): ____________________________________________________

Date: _______________________

____________________________________________________

Date: _______________________

____________________________________________________

Date: _______________________

____________________________________________________

Date: _______________________

Date information provided: __________________________________________________
Entity name (if the trustee is an entity): ________________________________________
Address of trustee(s): _______________________________________________________
_______________________________________________________
Telephone number of trustee(s): ______________________________________________

RETURN THIS INFORMATION SHEET TO THE ISSUING RECLAMATION OFFICE.
This report is required by Public Law 97-293. Information obtained in this form is protected by the Privacy Act of 1974, system of records
notice INTERIOR/WBR-31, and will be used to administer the acreage limitation provisions of Federal reclamation law. The Secretary of the
Interior or the district may require additional information in order to administer these laws.

Trustee Copy

Page 2 of 2

INSTRUCTIONS FOR COMPLETION
GENERAL Instructions
• When Reclamation has identified a trust that holds less than 40 acres westwide, Reclamation will determine if the
trustee should complete this “Trust Information Sheet” (Sheet). Reclamation will send this Sheet directly to the
trustee.
• If your trust holds more than 40 acres westwide, contact the Reclamation office that provided this Sheet for further
instructions.
• Press firmly when writing to ensure that all copies are legible.
• Visit www.usbr.gov/rra for more information.
RECLAMATION Instructions
• “For Reclamation Use Only” block: Complete all information.
• For recordkeeping purposes, retain the top half-sheet copy (“Originator Copy”) of page 1 of the Sheet at the time of
issuance.
• When the trustee has completed and returned the Sheet to Reclamation:
o Ensure the Sheet is complete.
o Retain the “Reclamation Copy.”
o Provide the “District Copy” to the appropriate district office (if applicable).
TRUSTEE Instructions
• Numbers 1 through 6: Enter the requested information.
• Number 7: Provide an accurate legal description or an assessor’s parcel number for the land(s) held in trust. Be
sure to break down land parcels as far as necessary to ensure accurate identification.
• Numbers 8 through 10: Enter the requested information. Note: “Current beneficiaries” refers to those that are
currently entitled to receive benefits from the trust.
• Number 11: Answer the questions. Please refer questions regarding completion of this item to the appropriate
Reclamation office.
• Complete the attestation section.
• Retain the “Trustee Copy.”
• Return the “Reclamation Copy” and the “District Copy” to the Reclamation office that issued this Sheet.
Refer questions to the Reclamation office that provided this Sheet.

7-2537 (07-11)
Bureau of Reclamation

OMB Control No.: 1006-0023
OMB Expiration Date: December 31, 2013

TRUST INFORMATION SHEET
(To be completed by the trustee of only those trusts that hold 40 acres or less westwide.)
[Use of this Sheet is to be initiated by Reclamation only.]
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
5 minutes per response. 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.

For Reclamation Use Only
District name(s):

Date Requested:

Trust name:

Originator Copy