OMB
		# 1076-0141 Expires
		MM/DD/YYYY BIA-DWP-Irr-105 Rev.
		2/2019 
		Land
		Classification / Designation Application 
 
 
	
|   
 
			 Requestor’s Name: 
			 
			 
				Applicable Definitions
				and Regulations: 
				Presently
				Assessable (PA) Definition: PA
				lands are categorized as those to which water can be delivered in
				their present state and by virtue of their physiographic and
				topographic conditions, and to which water from an existing
				project can generally be delivered, upon request, within a
				reasonable amount of time. PA lands are capable of economically
				producing crops under sustained irrigation. The failure of the
				landowner to provide internal ditches, perform minor leveling, or
				remove vegetation are not considered factors that prevent the PA
				designation of lands.  
				 
				Temporarily
				Non-Assessable (TNA) Definition/Regulation: USC Title 25 Chapter
				11 § 389a. TNA
				lands are lands that are temporarily not suitable for production
				of crops by the application of water, through no fault of the
				landowner or water user. “Where the Secretary finds that
				any such lands cannot be cultivated profitably due a present lack
				of water supply, proper drainage facilities, or need of
				additional construction work, he shall declare such lands
				temporarily non-irrigable for periods not to exceed five years
				and no charges shall be assessed against such lands during such
				periods.” Permanently
				Non-Assessable (PNA) Definition/Regulation: USC Title 25 Chapter
				11 § 389b. PNA
				lands are designated as permanently non-irrigable lands and
				eliminated from the irrigation project area. “Where the
				Secretary finds that any such lands are permanently non-irrigable
				he may, with the consent of the landowner, eliminate such lands
				from the project.”  It is BIA policy that changed land use
				is not sufficient reason to re-designate land to PNA. Any
				permanent changes to the land status will change the land from
				irrigated to dryland status and may reduce the value of the
				property, diminish the resale value of the land, and potentially
				impact water rights. Requested Designation (Select One): New Change Legal Description and Unit Serial No.: 
			 Current Designation: PA Acres: TNA Acres: PNA Acres:   Describe Conditions Justifying Proposed Designation, include Annual Assessment Waiver or Incentive Agreement information, and deficiencies of project infrastructure (include asset ID No.). Attach additional pages if necessary: 
 
 
 
 Proposed Designation: PA Acres: TNA Acres: PNA Acres: Signature: Date of Request: *Landowner: By signing this form I consent to PNA designation. If unit serial contains multiple landowners, I understand their consent must be obtained prior to final approval of PNA designation. | 
|   
 Unit Serial: Approve ☐ Disapprove ☐ Years approved for TNA (max. of 5):   Narrative Explanation: 
 
 
 
 Signature: Date: 
				B-1.
				PNA Designation – Land Designation Committee
				Section Chairman Recommendation: Approve ☐ Disapprove ☐ Signature: Date: 
					 Concurrences
					and Approval Section Agency Superintendent: Concur ☐ Non Concur ☐ Signature: Date: 
			 Regional Irrigation Engineer: Concur ☐ Non Concur ☐ Signature: Date: 
			 Regional Director: PA or TNA Designation: Approve ☐ Disapprove ☐ Signature:   C-1. PNA Designation Section Date: Regional Director: Concur ☐ Non Concur ☐ Signature: Date: 
			 Director, Bureau of Indian Affairs: Concur ☐ Non Concur ☐ Signature: Date: 
 
 Assistant Secretary – Indian Affairs: Approve ☐ Disapprove ☐ Signature: Date: | 
| INSTRUCTIONS Section A. Applicant: 
 
			 SUMMARY - Table of Determination, Recommendation, Concurrence, and Approval 
 
			 Refer to National Irrigation Handbook, Chapter 10, Land Designation and Assessment; and Indian Affairs Manual Part 50, Chapter 1, Irrigation for additional guidance. 
			 Paperwork Reduction Act Notice of 1995 - This information is being collected as required under the Debt Collection Improvement Act of 1996 (DCIA) from individuals and organizations doing business with the government. Public reporting burden for this form is estimated to average XX minutes per response. Direct comments regarding the burden estimate or any other aspect of this form to the Information Collection Clearance Officer, Bureau of Indian Affairs, 1849 C Street NW, MS-4144 MIB, Washington, DC 20240. Note: comments, names and addresses of commentators are available for public review during regular business hours. If you wish us to withhold this information you must state this prominently at the beginning of your comment. We will honor your request to the extent allowable by law. 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. The number and expiration date are displayed in the upper right corner of the form. 
			 Privacy Act Statement - The authority for requesting this information is contained in 25 U.S.C. Chapter 11, Irrigation of Allotted Lands; 31 U.S.C. 3711, Collection and Compromise; and 25 CFR Part 171 Irrigation Operations and Maintenance. The principal purpose for collecting this and other information is for billing and collecting O&M related costs upon assessable land designation, and may also include proper payment application and debt management actions. Lands so designated receive all the benefits of the project, and landowners are subject to all the responsibilities for project inclusion including repayment of O&M assessments and construction debt. The routine use of this information is to obtain minimum information for servicing the account if you own or lease land within an irrigation project where we assess fees and collect monies to administer, operate, maintain, and rehabilitate project facilities (25 CFR Section 171.105). Disclosure of information may be to: U.S. Department of Justice or in a proceeding before a court or adjudicative body; Federal, state, local, or foreign law enforcement agency; Members of Congress; Department of Treasury to effect payment; Federal agency for collecting a debt; and other Federal agencies to detect and eliminate fraud. The information may also be used for filing tax documents with the Internal Revenue Service (IRS) as required by law pursuant to the routine uses identified in the National Irrigation Information Management System (NIIMS), Interior, BIA-34. Providing the information is voluntary; however, not doing so will prevent you from participating in an Assessment Waiver, and Incentive Agreement, a Land Classification/Designation, and/or a Payment Plan as well as making payment through Pay.gov and NIIMS. If payment is not received, we will not deliver water; your debt will be referred to Treasury for collection actions; and your lease, if any, may be cancelled. | 
	
	
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Mcgarvey, Mary Elizabeth | 
| File Modified | 0000-00-00 | 
| File Created | 2023-08-29 |