7-21SUMM-R District S ummary of Reporting and declaration Forms

OMB CONTROL NO.: 1006-0006

FORM 7-21SUMM-R
2012

DISTRICT SUMMARY OF REPORTING AND
DECLARATION FORMS

1. District Name:

2. Total number of pages
including this page:

3. Project, unit, and/or division name:

4. Region:

(7-11)
BUREAU OF RECLAMATION

Do not use this form after December 31, 2012. Type or print in ink. Date and initial crossouts and corrections. Visit www.usbr.gov/rra for more information.
5(a). Your district is a category 2 district, because a prior law district is always a category 2 district.
5(b). Does the District anticipate delivering Reclamation irrigation water this year? (check one):
(a)
Number of
Landholders

6.

Acreage Directly
Owned
(b) Number

(c) Acres

□ YES

□ NO

Acreage Directly Leased
FROM Other Parties
(d) Number

(e) Acres

Directly Owned
Excess Acreage
(f) Number

(g) Acres

Directly Held
Full-Cost Acreage
(h) Number

(i) Acres

Individuals and entities (Tabulation A)
40 through 160
Over 160 through 320

7.

Over 320
Trusts and estates (Tabulation B )
Over RRA forms submittal threshold through 160
Over 160 through 320
Over 320

8.
9.

Public entities (Tabulation C )
Religious and charitable organizations
(Tabulation D )
10. Nonreporting landholdings over
RRA forms submittal threshold (Tabulation E )
11. Total landholdings over RRA
forms submittal threshold
12. Estimated landholdings below
RRA forms submittal threshold
13. Grand total (items 11 and 12)
14. I ATTEST THAT THIS INFORMATION IS BASED ON LANDHOLDERS’ REPORTING FORMS AND ACCURATELY REPRESENTS THE INFORMATION SUBMITTED BY THE LANDHOLDERS.
I FURTHER ATTEST THAT ALL KNOWN ERRORS, OMISSIONS, AND DISCREPANCIES IN THE LANDHOLDERS’ FORMS ARE LISTED ON FORM 7-21SUMM-R, TABULATION E. THIS FORM
MUST BE SIGNED AND DATED BY AN AUTHORIZED DISTRICT OFFICIAL.

Signature

Title

Date

OMB CONTROL NO.: 1006-0006
BUREAU OF RECLAMATION

FORM 7-21SUMM-R
Tabulation A
2012

District Name:

DISTRICT SUMMARY OF REPORTING AND
DECLARATION FORMS
TABULATION A of Individual and Entity Reporting Forms
(Forms 7-2190, 7-2190EZ, and 7-2191)

(7-11)

Do not use this form after December 31, 2012. Type or print in ink. Date and initial crossouts and corrections. Visit www.usbr.gov/rra for more information.
LANDHOLDINGS OF (choose only one):

□ 40 through 160

□ Over 160 through 320

(a)
Name of Direct Landholder

□ Over 320

(c)
Acreage* Directly
Owned in
This District

(b)
Multidistrict

1.
2.

(d)
Acreage* Directly
Leased FROM Other
Parties
in This District

(e)
Directly Owned
Excess Acreage*
in This District

(f)
Directly Held
Full-Cost Acreage*
in This District

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)

3.

(a)

4.

(a)

(b)

(c)

(d)

(c)

(d)

(e)

(f)

TOTAL NUMBER OF ACRES
TOTAL NUMBER OF LANDHOLDERS

(b)

[on this page]

*Irrigable and/or irrigation acres.

OMB CONTROL NO.: 1006-0006
BUREAU OF RECLAMATION

FORM 7-21SUMM-R
Tabulation B
2012

District Name:

DISTRICT SUMMARY OF REPORTING AND
DECLARATION FORMS
TABULATION B of “Declaration of Trust’s or Estate’s
Landholdings” Forms
(Form 7-21TRUST)

(7-11)

Do not use this form after December 31, 2012. Type or print in ink. Date and initial crossouts and corrections. Visit www.usbr.gov/rra for more information.
LANDHOLDINGS OF (choose only one):

□ Over RRA Forms Submittal Threshold Through 160

(a)
Name of Trust or Estate

(b)
Multidistrict

1.
2.

□ Over 160 Through 320

(c)
Acreage* Directly
Owned
in This District

□ Over 320

(d)
Acreage* Directly
Leased FROM Other
Parties
in This District

(f)
Directly Held
Full-Cost
Acreage* in
This District

(e)
Directly Owned
Excess
Acreage* in
This District

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)

3.
4.

TOTAL NUMBER OF ACRES
TOTAL NUMBER OF LANDHOLDERS

(a)

(b)

(a)

(b)

(c)

(d)

(c)

(d)

(e)

(f)

[on this page]

*Irrigable and/or irrigation acres.

OMB CONTROL No: 1006-0006
BUREAU OF RECLAMATION

DISTRICT SUMMARY OF REPORTING AND
DECLARATION FORMS
TABULATION C of “Declaration of Public Entity’s
Landholdings” Forms
(Form 7-21PE)

FORM 7-21SUMM-R
Tabulation C
2012

District Name:

(7-11)

Do not use this form after December 31, 2012. Type or print in ink. Date and initial crossouts and corrections. Visit www.usbr.gov/rra for more information.
(a)
Name of Public Entity

(b)
Multidistrict

1.

(c)
Acreage* Directly
Owned and NOT
Leased to or NOT
Operated by Other
Parties
in This District

(d)
(e)
(f)
Acreage* Directly
Acreage* Directly
Acreage* Directly
Owned and
Owned and Subject Leased and Subject
Leased to or
to Acreage Limitation to Acreage Limitation
Operated by Other
Application
Application
Parties
in This District
in This District
in This District

(g)
Directly Owned
Excess Acreage*
in This District

(h)
Directly Held
Full-Cost Acreage*
in This District

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)

2.

(a)

3.

(a)

(b)

(c)

(d)

(e)

(f)

(c)

(d)

(e)

(f)

(g)

(h)

TOTAL NUMBER OF ACRES
TOTAL NUMBER OF LANDHOLDERS

(b)

[on this page]

*Irrigable and/or irrigation acres.

OMB CONTROL NO.: 1006-0006
BUREAU OF RECLAMATION

FORM 7-21SUMM-R
Tabulation D
2012

DISTRICT SUMMARY OF REPORTING AND
DECLARATION FORMS

District Name:

TABULATION D of “Report of Religious or Charitable
Organization’s Landholdings” Forms
(Form 7-2194)

(7-11)

Do not use this form after December 31, 2012. Type or print in ink. Date and initial crossouts and corrections. Visit www.usbr.gov/rra for more information.
(a)
Name of Religious or Charitable Organization

(b)

(c)
Acreage* Directly
Owned
in This District

Multidistrict

1.

(d)
Acreage* Directly
Leased FROM
Other Parties
in This District

(e)
Directly Owned
Excess Acreage*
in This District

(f)
Directly Held
Full-Cost Acreage*
in This District

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)

2.

(a)

3.

(a)

(b)

(c)

(d)

(c)

(d)

(e)

(f)

TOTAL NUMBER OF ACRES
TOTAL NUMBER OF LANDHOLDERS

(b)

[on this page]

*Irrigable and/or irrigation acres.

OMB CONTROL NO.: 1006-0006
BUREAU OF RECLAMATION

FORM 7-21SUMM-R
Tabulation E
2012

DISTRICT SUMMARY OF REPORTING AND
DECLARATION FORMS
TABULATION E of Reporting Form Errors,
Omissions, and Discrepancies

District Name:

(7-11)

Do not use this form after December 31, 2012. Type or print in ink. Date and initial crossouts and corrections.
For additional space, use as many copies of this sheet as necessary. Visit www.usbr.gov/rra for more information.

1.

Landholders that hold land over the RRA forms submittal threshold requiring reporting that did not receive Reclamation irrigation water and that did not submit a form:
(a) Name of Landholder

(a) Name of Landholder

(b) Number of Acres*
in This District

(1)

(16)

(2)

(17)

(3)

(18)

(4)

(19)

(5)

(20)

(6)

(21)

(7)

(22)

(8)

(23)

(9)

(24)

(10)

(25)

(11)

(26)

(12)

(27)

(13)

(28)

(14)

(29)

(15)

2.

(b) Number of Acres*
in This District

(30)

Landholders that hold land over the RRA forms submittal threshold that received Reclamation irrigation water and that did not submit a form:
(a) Name of Landholder

(b) Number of Acres*
in This District

(c) Reason or Explanation for Water Delivery

(1)
(2)
(3)

3.

Landholders that hold land over the RRA forms submittal threshold requiring reporting that submitted a form, but had an error, omission, or discrepancy on the form:
(a) Name of Landholder

(b) Received
Reclamation Irrigation
Water?

YES

NO

(1)
(2)
(3)
*Irrigable and/or irrigation acres.

(c) Explanation of the Error, Omission, or Discrepancy

OMB CONTROL NO.: 1006-0006
BUREAU OF RECLAMATION

DISTRICT SUMMARY OF REPORTING AND
DECLARATION FORMS
TABULATION F of Part Owners Subject to
Prior Law Provisions

FORM 7-21SUMM-R
Tabulation F
2012

District Name:

(7-11)

Do not use this form after December 31, 2012. Type or print in ink. Date and initial crossouts and corrections. List only indirectly held lands. DO NOT transfer information from this sheet to
Form 7-21SUMM-R, “District Summary of Reporting and Declaration Forms.” This tabulation sheet is provided for district convenience only and is not required pursuant to the
Reclamation Reform Act of 1982 forms requirements. Visit www.usbr.gov/rra for more information.
(a)
Name of Part Owner

(b)
Name of Entity, Trust or Estate

(c)
Multidistrict

1.

(d)
Does This Part
Owner Directly
Own or Lease
Lands in Their
Name in This
District?
YES

(e)
Acreage*
Indirectly
Owned
Through
Entities in
This District

(f)
Acreage*
Indirectly
Leased
Through
Entities in
This District

(g)
(h)
Indirectly
Indirectly
Owned Excess Held Full-Cost
Acreage* in
Acreage* in
This District
This District

NO

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)

2.

TOTAL NUMBER OF ACRES
(b)

(a)

3. TOTAL NUMBER OF LANDHOLDERS

[on this page]

*Irrigable and/or irrigation acres.

(a)

(b)

(c)

(d)

(c)

(d)

(e)

(f)

OMB CONTROL NO.: 1006-0006
BUREAU OF RECLAMATION

(7-11)

FORM 7-21SUMM-R
Tabulation G
2012

DISTRICT SUMMARY OF REPORTING AND
DECLARATION FORMS

District Name:

TABULATION G of “Declaration of Farm Operator Information” Forms
(Form 7-21FARMOP)

Do not use this form after December 31, 2012. Type or print in ink. Date and initial crossouts and corrections. Visit www.usbr.gov/rra for more information.
(b)
Check appropriate
column

(a)
Name of Farm Operator or Part Owner
(as shown in item 1. of Form 7-21FARMOP)

Farm
Operator

(c)

Multidistrict

1.

Part Owner
of a Farm
Operator

(d)
Number of Acres*
to Which Services
Are Provided in This
District

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(a)

2.
3.

TOTAL NUMBER OF ACRES
TOTAL NUMBER OF FARM OPERATORS AND PART OWNERS

(a)
[on this page]

*Irrigable and/or irrigation acres.

(b)

(c)

(d)