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NOTICE The Privacy Act of 1974 and the regulation in 43 CFR 2.48(d) provide [hat you be furnished the following information in connection with information required by [his apphcation. AUTHORITY: 30 U.S.C. 601, 602; 43 U.S.C. 1201; 60 Stat 367 PRINCIPAL PURPOSE -The information is to be used to process your application for a Free Use Permit. ROUTINE USES: (lj The adjudication of the applicants'rights to the land or resources. (2) Documentation for public information in support of.notations made on land status records for the management, disposal, and use of public lands and resources. (3) Transfer to appropriate Federal agencies when concurrence is required prior to granting a rght in public lands or resourcs. - (4) Transfer to the U.S. Department of Justice inthe event of litigation involving the records or[he subject matter of the records. (5) Transfer, in the event there is indicated a violation or potential violation of a statute, regulation, rule, order or license, whether civil, criminal or regulatory in nature, [o [he appropriate agcnry or agencies, whether Federal, State, local or foreign, charged with the responsibility of investigation or prosecuting such violation or chargcd with enforcing or implementing [he statute, rule, regulation, order or license violated or potentially violated. EFFECT OF NOT PROVIDING INFORMATION - I[you do not furnish all the information required by this form, your application may be rejected. The Paperwork Reduction AM of 1980 (44 U.S.C. 3501 et. seq.) requires us to inform you that: Information is being collected to obtain vegetal and mineral depletion information relevant to natural resource inventory. Information will be used for depletion records. Response to [his request is mandatory (43-5510) to fulfdl the requirements for the cutting of timber and for oil and gas claimants. BURDEN HOUAS STATEMENT Public repotting burden for this form is estimated to avenge 5 minutes per raponse, including the time for reviewing instructions, gathering anti mainuiaing data, and completing anti reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Department of the Interior, Bureau of Land Management, (Altemam) Bureau Clearance Officer, (WO-771), 1849 C Sueet, N.W., Washington, D.C. 207A0, anti the OCLce of Maoagemem and Budget, Paperwork Reductiou Project (1004- 0001), Washingmn, D.C. 20503.