Form 5-5015 Navajo Partitioned Lands: Grazing Permit

OMB 1076-0162 Form 5-5015

Expires XX/XXXX

United States

Department of the Interior

Bureau of Indian Affairs

Navajo Partitioned Lands Grazing Permit

Grazing Permit No.:__________

______________________________ ____________ ___________ _____________________

Name of Grazing Permittee Census Number Range Unit # (Range Management Plan)

____________________________________________________________________ ________________

(Description of the Permitted Area) (Carrying Capacity)

Kind of livestock	Number of head	Sheep units	Stocking rate	Total sheep units
Cattle
Sheep / Goats
Total

Animal Identification _______________ _______________ _____________ _ _____________

(Brand) (Location: Left Hip) (Earmark) (Tribal/State)

Premise Identification ____________ TERM OF GRAZING PERMIT ____________ _____________

(GPS) Beginning Date Ending Date

On or before January 01, is livestock Tally received YES / NO? Is permittee in compliance YES / NO? OPTION to Renew / Extend / Suspend.

PROVISIONS AS SET FORTH FOR GRAZING PERMITTEE:

1. Permittee agrees that he or she will not use, cause, or allow to be used any part of the permitted area for any unlawful conduct or purpose.

2. The grazing permit authorizes no other privilege than grazing use.

3. The grazing regulations and the required range unit Range Management Plan provide the terms under which livestock grazing is permitted and managed. Please attach the range unit Range Management Plan.

4. No person is allowed to hold a grazing permit in more than one range unit of the Navajo Partitioned Lands (exclusion unless the customary use area extends beyond the range unit boundary).

5. The Bureau of Indian Affairs and the Navajo Nation reserve the right of entry for range survey, inventory, inspection and compliance purposes.

6. Individuals will prohibit the creation of a nuisance, any illegal activity, and negligent use or waste of resources.

7. All trespass, sale of seized stock; disposition of proceeds will be in accordance with NNC 3 §1307.

8. Navajo Nation Council Resolution CO-59-03 Approving and Promulgating Rules for Land, Grazing and Farming disputes will be applicable.

9. Grazing permits cannot be subdivided once it has been issued.

10. Other provisions that is discretionary for the Bureau of Indian Affairs with the concurrence of the Navajo Nation to protect the land and/or resources. _______________________________________

_________________________________________________________________________________

11. Permit Modification, when the Navajo Nation approves a land withdrawal, the grazing permit will be modified to reflect the change in available forage. The withdrawn land will be excluded from the grazing permit, and grazing cannot take place on that part of the range unit.

RESTRICTIONS PLACED ON GRAZING PERMITS:

1. Only a grazing permit issued under this part authorizes the grazing of livestock within the Navajo Partitioned Lands. (25 CFR, 161.302)

2. Grazing permits will not be issued for less than 10 sheep units.

3. Grazing permits will not exceed 350 sheep units.

4. Permittee must meet the eligibility criteria set forth by the Navajo Nation RDCF-20-17.

5. Carrying capacity and stocking rates of each range unit will determine the number of livestock, and or wildlife that can be grazed on each range unit.

6. This permit shall not be fractionated, assigned, or transferred except as provided in said Grazing Regulations

By AUTHORITY of law and pursuant to the regulations in Part 161 – Navajo Partitioned Lands Grazing Permits Regulations, Title 25 C. F. R. and amendments thereto, the above named Navajo is hereby granted permission to hold and graze the number and kind of livestock as specified above on the Navajo Partitioned Lands for the time and in the range unit as stated above and thereafter until further notice, subject to compliance with the Range Management Plan for the range unit and any changes made in accordance with and pursuant to the said Grazing Regulations as amended.

The Regional Director shall make decisions relative to the interpretation of the terms of this permit and enforcement of Grazing Regulations.

Issued at the Navajo Area Region on this _______________ day of __________, 20 __________

___________________________________________

(Regional Area Director)

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

In accordance with authority contained in Navajo Nation Resources Development Committee resolution of February 14, 2017 section III Eligibility requirements to qualify for issuance of a grazing permit on Navajo Partitioned Lands. Number 6 should new permits be issued for the NPL under 25 CFR 161.401 legally recognized heirs of the permittee will have first priority.

I __________________________________ Census No. ___________________________

(Name)

The holder of the grazing permit within assigned range unit _______ hereby designate,

____________________________________ Census No. ___________________________

(Name)

To receive this assignment upon my death subject to approval of this designation by the heirship process and the concurrence of the Bureau of Indian Affairs.

The beneficiary ________________________________________

(Name)

Understands that acceptance of this request subjects him or her to all conditions of the original eligibility requirements RDCF-20-17 to assume this assignment.

______

Date ________________________ signed _______________________________________________________________

(Print Name) (Signature)

Witnessed: Witnessed:

________________________________________________ _____________________________________________

Paperwork Reduction Act Statement: This information is collected to manage agriculture and grazing permits. The information is supplied by a respondent to obtain or retain a benefit, that is, a permit. It is estimated that responding to the request will take an average of 1 hour to complete. If you wish to make comments on the form, please send them to: Information Collection Clearance Officer, Office of Regulatory Affairs – Indian Affairs, 1849 C Street, NW, Mail Stop 4141, Washington, DC 20240. Comments, including names and addresses of respondents, will be available for public review at this Indian Affairs address during business hours. Before including your address, phone number, e-mail address, or other personal identifying information in your comment, you should be aware that your entire comment—including your personal identifying information—may be made publicly available at any time. In compliance with the Paperwork Reduction Act of 1995, as amended, the collection has been reviewed by the Office of Management and Budget and assigned a number and expiration date. The number and expiration date are at the top right corner of the form. Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless there is a valid OMB clearance number.

Privacy Notice: Authority: 25 CFR 161, Navajo Partitioned Lands Grazing Permits.  Purpose: The principal purpose for collecting the information is to determine eligibility to obtain a Navajo Partitioned Lands Grazing Permit.  Routine Uses: The information will be used by the Bureau of Indian Affairs (BIA) in determining whether an applicant is eligible and complies with all applicable grazing permit requirements. Information collected may be shared with Navajo Nation members applying for a permit, the Navajo Tribal Government; U.S. Department of Agriculture, and U.S. Department of Justice.  Disclosure: Voluntary; however, if information is not provided, the BIA cannot make a determination on whether the applicant is eligible and complies with all applicable grazing and compliance requirements, which may result in non-acceptance of this application or determined not eligible to receive a permit to graze livestock.

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