OMB Control Number: 1090-0011
Expiration: 8/31/18
	
Please indicate below the locations at which you own fractional interests and ACCEPTED all or some part of the purchase offer provided by the Buy-Back Program:
	      Cheyenne
	River 
      Coeur
	d’Alene
      Crow
	Nation
      Flathead 
      Fort
	Belknap 
      Fort
	Peck
      Gila
	River 
      Lake
	Traverse 
      Makah
      Northern
	Cheyenne 
      Pine
	Ridge 
      Prairie
	Band of Potawatomi Nation
      Quapaw 
      Rosebud 
      Salt
	River 
      Squaxin
	Island 
      Standing
	Rock Sioux 
      Swinomish 
      Umatilla 
	
	
Please indicate below the locations at which you own fractional interests and DID NOT ACCEPT any part of the purchase offer provided by the Buy-Back Program:
	
	
	      Cheyenne
	River 
      Coeur
	d’Alene
      Crow
	Nation
      Flathead 
      Fort
	Belknap 
      Fort
	Peck
      Gila
	River 
      Lake
	Traverse 
      Makah
      Northern
	Cheyenne 
      Pine
	Ridge 
      Prairie
	Band of Potawatomi Nation
      Quapaw 
      Rosebud 
      Salt
	River 
      Squaxin
	Island 
      Standing
	Rock Sioux 
      Swinomish 
      Umatilla 
	
	
If you chose to SELL any of your land interests, please identify the reasons why you chose to sell (check all that apply):
	
	
 I was satisfied with the amount that was offered
 I wanted the tribe to have ownership of the land
 I was motivated by the tribal government’s plan for using consolidated land
 I was not able to use the land because it was fractionated
 I was advised by friends and/or family to sell the land
 I wanted the land to be available to the community and to future generations
 I did not make use of my land or did not receive enough income from it
 Other: __________________________________________________________________________
	
	
If you chose NOT to sell some or all of your land interests, please identify below the reasons why you chose NOT to sell (check all that apply):
	
	
 I was confused by the purchase offer packet
 I missed the deadline
 I wasn’t offered enough money for my land
 I wanted to keep my land because I live on it
 I want to keep my land because I earn income from it
 I want to keep my land because it is important that it stay in my family
 I was advised by friends and/or family not to sell the land
 I did not feel I had enough information to make a decision
 I was unaware of how my tribal government would use the land
 I have signed a will that describes how my land will transfer upon my death
 Other: __________________________________________________________________________
	
	
Before receiving your purchase offer, how familiar were you with the Buy-Back Program?
	
	
 Very familiar
 Somewhat familiar
 Not familiar at all
	
	
From which sources did you receive information about Buy-Back Program? Please check all that apply AND rate their usefulness:
Very Somewhat Not Useful
Useful Useful
 Friends/neighbors   
 Social media (Facebook /Twitter)   
 Newspapers   
 Radio announcements   
 Television announcements   
 Tribal leadership   
 Local BIA staff   
 Local OST staff   
 Trust Beneficiary Call Center   
 Purchase Offer Package   
 Postcards   
 Mail sent by the tribe   
 Community meetings, events, or   
information sessions   
 None of the above
	
	
How satisfied were you with the following aspects of the Land Buy-Back Program?
	
	
Very Satisfied Satisfied Somewhat Dissatisfied Dissatisfied
Outreach by federal staff    
Accuracy of information provided    
Sale payment processing time    
Offer packet ease of use    
Trust Beneficiary Call Center    
	
	
Overall, what is your opinion of the Buy-Back Program?
	
	
 Very positive
 Somewhat positive
 Somewhat negative
 Very negative
	
	
If you have further thoughts, comments, or feedback about the Buy-Back Program, please email [email protected] and include the words “Survey response” in the email title.
	
	
	
	
PAPERWORK REDUCTION ACT STATEMENT: A Federal 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 OMB control number. Public burden for the collection of this information is estimated to average 5 minutes per response and the response is voluntary. You may direct comments regarding the burden estimate or any other aspect of this collection of information to the Land Buy-Back Program Office at [email protected].
	
	
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Johnson, Treci Camille | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-25 |