AD-1157 Option Agreement to Purchase

U.S. DEPARTMENT OF AGRICULTURE

OMB No. 0578-0013

1. To be completed by NRCS; check appropriate box.

This transaction is for CCC
This transaction is for NRCS

OPTION AGREEMENT TO PURCHASE
2. OPTION AGREEMENT TO PURCHASE NO.

This Option Agreement is between the United States of America (hereafter “United States”), and the
following named Landowner(s), their heirs, successors and assigns (hereafter “Landowner”):
3. Landowner Name:
4. Landowner Address:

In consideration of One Dollar ($1.00), receipt of which the Landowner acknowledges, the United States
and the Landowner agree that:
1.

If the United States exercises this option to purchase, the Landowner agrees to convey an easement to the
United States. The easement is attached as EXHIBIT A and encumbers the land generally described or
depicted on EXHIBIT B, (hereafter the “Property”). Except for normal farming, pasturing, and grazing,
the Landowner agrees not to do, or allow others to do, any act by which the value or title to the Property
may be diminished or encumbered.

2.

Subject to the terms of this Agreement, the United States will pay the Landowner (A) $
for conveyance of the easement. The Landowner agrees to accept this amount as the full and final
compensation for the easement. This offer is based on an estimated (B)
acres subject to
change based on final acreage determination.

3.

The United States will arrange for closing of the easement conveyance which may involve use of a title
company or other closing agent. CCC will secure at its expense title evidence sufficient to meet Federal
standards.

4.

At closing, the Landowner agrees to execute an easement deed in the form described in EXHIBIT A,
along with any other document which is necessary for the United States to acquire a satisfactory title to
the Property. The Landowner shall pay at closing any conveyance taxes and taxes owing against the
Property.

5.

With prior notice to the Landowner, the United States may hereafter enter upon the Property for planning
and acquisition purposes prior to closing. At its cost, the United States may survey and monument the
Property and any associated access route.

6.

All terms and conditions of this Agreement are expressly stated herein, and there are no other related
representations or promises. No Member of or Delegate to Congress, or Resident Commissioner shall be
admitted to any share or part of this Agreement or benefit from it.

7.

This agreement is effective for (A)
months from the date of execution below. During that period, the
United States has the option to acquire the easement for the stated purchase price.

8.

Except for reasons beyond the control of the Landowner, if the Landowner fails to convey the easement,
the Landowner will be in default and shall pay the United States the amount of costs incurred by the
United States for survey and all other actions taken after the date, and in furtherance, of this Option
Agreement.
The signature by the NRCS representative signifies a CCC or NRCS
transaction as indicated above.

AD-1157
rev.

OMB No. 0578-0013

OPTION AGREEMENT TO PURCHASE NO.

9. Executed this (A)

day of (B)

, (C)

10. Landowner(s)
11. Title (if applicable)
12. United States
13. Title

This instrument was drafted by the Office of the General Counsel, U.S. Department of Agriculture, Washington,
D.C. 20250-1400.

OMB DISCLOSURE STATEMENT
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not
required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB
control number for this information collections is 0578-0013. The time required to complete this information
collection is estimated to average 40 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection
information.

NONDISCRIMINATION STATEMENT
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its program and activities on the basis
of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental
status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an
individual's income is derived from any public assistance program. (Not all prohibited bases apply to all programs.)
Persons with disabilities who require alternative means for communication of program information ( Braille, large
print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a
complaint of Discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW.,
Washington, DC 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal
opportunity provider and employer.
PRIVACY ACT STATEMENT
The above statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 522a). Furnishing this
information is voluntary; however, failure to furnish correct, complete information will result in the withholding or
withdrawal of such technical or financial assistance. The information may be furnished to other USDA agencies, the
Internal Revenue Service, the Department of Justice, or other State or Federal law enforcement agencies, or in
response to orders of a court, magistrate, or administrative tribunal.

OMB No. 0578-0013

The signature by the NRCS representative signifies a CCC or NRCS
transaction as indicated above.

AD-1157
rev.

U.S. DEDEPARTMENT OF AGRICULTURE

OMB NO. 0578-0013
AD-1157

OPTION AGREEMENT TO PURCHASE

OMB BURDEN STATEMENT
Federal Agencies may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid
OMB control number. Public reporting burden for this collection of information is estimated to average 40 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden, to Department of Agriculture, Clearance Officer, OIRM (OMB NO. 0578-0013), Stop 7630, Washington, D.C. 20250-7630.