Form 5450-17 Export Determination

Form 5450-017
(July 2021)

FORM APPROVED
OMB NO. 1004-0058
Expires: Dec. 31, 2024

UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT

Location of facility where Federal timber is
expected to be processed:

EXPORT DETERMINATION

In compliance with requirements of 43 CFR 5424.1,

I

We

hereby submit the following information:

(1) Have you exported unprocessed private timber, or if a sourcing area is established, have you exported private timber from
lands tributary to the above processing facility, in the 24 months prior to the auction or purchase date of Federal timber?
☐ Yes ☐ No - Last Export Date (if any within the past 5 years)
(2) If the answer in (1) is yes, you are not eligible to purchase federal timber until at least 24 months from the date in (1).
(3) Have any of your affiliates* exported unprocessed private timber, or exported unprocessed private timber from lands tributary
to the above processing facility if within an established sourcing area, within the 24 months prior to the auction or purchase
date of the Federal timber? ☐ Yes ☐ No - Provide affiliate names and last export dates (if any, list latest export date within
the past 5 years):
a. Affiliate

Last Export date

b. Affiliate

Last Export date

c. Affiliate

Last Export date

(4) If any affiliates have exported unprocessed private timber within 24 months of the auction or purchase date of the Federal
timber, you are not eligible to purchase federal timber until at least 24 months from the most recent export date shown in (3).
*From 43 CFR 5400.0-5: Affiliate means a business entity including but not limited to an individual, partnership, corporation, or association, which controls or is
controlled by a purchaser, or, along with a purchaser, is controlled by a third business entity. From 16 USC 620e: Export prohibition applies to any individual,
partnership, corporation, association, or other legal entity and includes any subsidiary, subcontractor, or parent company, and business affiliates where one affiliate
controls or has the power to control the other or when both are controlled directly or indirectly by a third person.

Name of Firm:

Signature of Signing Officer

Title

Date

By signing this form, you certify that you or your affiliates have not exported unprocessed private timber within the 24 months prior to the sale date of Federal timber and
will not export unprocessed private or federal timber for the duration of the federal timber sale. Timber export and substitution violations are subject to civil penalties
described in 16 USC 620d and may result in monetary damages and suspension and debarment.

INSTRUCTIONS: The Purchaser must complete the form and return to the Contracting Officer. In the event the Purchaser elects to
sell any or all of the timber sold under this contract in the form of unprocessed timber, the Purchaser shall require each party buying,
exchanging, or receiving such timber to complete a copy of this form and file the form with the Contracting Officer.
Timber Sale Name and Number:

Return Form to Contracting Officer at:

Unprocessed timber means trees or portions of trees or other roundwood not processed to standards and specifications suitable for end-product use. The term
"unprocessed timber" does not include timber processed into any one of the following: (i) Lumber or construction timbers, except Western Red Cedar, meeting current
American Lumber Standards Grades or Pacific Lumber Inspection Bureau Export R or N list grades, sawn on 4 sides, not intended for remanufacture; (ii) Lumber,
construction timbers, or cants for remanufacture, except Western Red Cedar, meeting current American Lumber Standards Grades or Pacific Lumber Inspection Bureau
Export R or N list clear grades, sawn on 4 sides, not to exceed 12 inches in thickness; (iii) Lumber, construction timbers, or cants for remanufacture, except Western
Red Cedar, that do not meet the grades referred to in clause (ii) and are sawn on 4 sides, with wane less than ¼ of any face, not exceeding 8¾ inches in thickness; (iv)
Chips, pulp, or pulp products; (v) Veneer or plywood; (vi) Poles, posts, or piling cut or treated with preservatives for use as such; (vii) Shakes or shingles; (viii) Aspen
or other pulpwood bolts, not exceeding 100 inches in length, exported for processing into pulp; (ix) Pulp logs, cull logs, and incidental volumes of grade 3 and 4 sawlogs
processed at domestic pulp mills, domestic chip plants, or other domestic operations for the primary purpose of conversion of the logs into chips, or to the extent that a
small quantity of such logs are processed, into other products at domestic processing facilities.
(continued on page 2)

Form 5450-017, page 1

NOTICES
The Privacy Act and 43 CFR 2.48(d) require that you be furnished with the following information in connection with the information
requested by this form.
AUTHORITY: 16 USC 620 and 43 CFR Part 5420 permit collection of the information requested by this form.
PRINCIPAL PURPOSE: The BLM uses the information in this form to determine eligibility to purchase federal timber.
ROUTINE USES: Timber sale purchaser provides information regarding their export of private timber.
EFFECT OF NOT PROVIDING INFORMATION: Submission of the requested information is required to obtain or retain a benefit.
Failure to submit all of the requested information or to complete this form may result in delay or preclude the BLM’s acceptance of your form.
The Paperwork Reduction Act requires us to inform you that:
The BLM collects this information to determine whether Federal timber has been substituted for exported private timber in accordance
with 43 CFR 5424.1 and 5424.0-6(e).
You do not have to respond to this or any other Federal agency-sponsored information collection unless it displays a currently valid OMB
control number.
BURDEN HOURS STATEMENT: The estimated public reporting burden for this form is 1 hour per response for a majority of responses,
including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. You may submit
comments regarding the burden estimate or any other aspect of this form to: U.S. Department of the Interior, Bureau of Land Management
(1004-0058), Bureau Information Collection Clearance Officer, 1849 C Street, N.W., Room 2134 LM, Washington, D.C. 20240.

Form 5450-017, page 2