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<br />Y <br />NOTICE <br />The Privacy Act of 1974 and [he regulation in 43 CFR 2.48(d) <br />provide that you be furnished the following information in <br />connection with information required by this application. <br />AUTHORITY: 30 U.S.C. b01, 602; 43 U.S.C. 1201; 60 Stat. 367 <br />PRINCIPAL PURPOSE -The information is to be used to <br />process your application for a Free Use Permit. <br />ROUTINE USES: <br />(1) The adjudication of the applicants' rights to the land <br />or resources. <br />(2) Documentation for public information in support of no- <br />tations made on land status records for the management, <br />disposal, and use of public lands end resources. <br />(3) Transfer to appropriate Federal agencies when concur- <br />rence is required prior to granting a right in public <br />lands or resources. <br />(4) Transfer to the U.S. Department of Justice in the event <br />cf litigation involving the records or the subject matter <br />of the records. <br />(5) Transfer, in the event there is indicated a violation or <br />potential violation of a statute, regulation, rule, order <br />or license, whether civil, criminal or regulatory in nature, <br />to the appropriate agency or agencies, whether Federal, <br />State, kcal or foreign, charged with the responsibility <br />of investigation or prosecuting such violation or charged <br />u~i[h enforcing or implementing the statute, rule, regu- <br />lation, order or license violated or potentially violated. <br />EFFE(:T OF NOT PROVIDING INFORMATI Ot,I - If you do not <br />furnish alt the information required by this form your application <br />may be rejected. <br />~ ,- ~ t~ <br />