Form FS-2400-0017 Consent to Conduct Timber Sale or Integrated Resource Ti

Consent to Conduct Timber Sale or

Integrated Resource Timber Contract Business Electronically

(15 U.S.C 7001) FS-2400-0017 (REV. XX/XXXX)

OMB 0596-0225 (EXP. XX/XX/XXXX)

I/We, Purchaser/Contractor __________________ hereby consent to conduct timber contract administration business electronically on the _______________ National Forest.

Terms and Conditions:

Purchaser/Contractor agrees, subject to the civil and criminal penalties prescribed in 18 U.S.C. 1001, that [applying or affixing] your electronic signature to this consent and other timber contract administration documents, you agree to conduct business electronically and are bound to this consent and timber contract administration documents with the same force and effect of law as if you signed with a manual/handwritten signature. You affirm that your electronic signature on this consent, and all future electronic signatures on timber contract administration documents, are signed by authorized representatives of the contract holder with full knowledge and consent and are legally bound to these terms and conditions.

Electronic business includes but is not limited to, receiving notices, executing modifications and agreements and submitting, applications, requests and other documentation via electronic means. Further, even though Purchaser/Contractor has provided this consent, the Forest Service may at its option deliver any documents, notices or other communications to the Purchaser/Contractor in paper and may require that certain communications be delivered to the Forest Service in paper. Purchaser/Contractor is responsible for printing or saving all documents, agreements, notices and communications for your records.

Purchaser/Contractor understands they may withdraw consent to do business electronically by providing the Forest Service with written notice. Withdrawal of consent will become effective upon receipt by the Forest Service. Thereafter, all documents, notices and communications will be provided by the Forest Service on paper. Any further requests, applications and correspondence will need to be submitted via paper.

Representatives:

Purchaser/Contractor and their Representatives shall have an email account capable of receiving electronic communications from Forest Service. You agree to provide email addresses for all designated representatives pursuant to contract provision B/BT6.1. Purchaser/Contractor will update Forest Service of any changes to Representative’s contact information, including email address. Purchaser/Contractor is responsible for keeping access to their email address secure. Any documents, agreements, applications, or requests received by Forest Service from designated email addresses shall be binding under the terms of the contract. Forest Service is only required to communicate with you using the most recent contact information provided.

(Name Of Purchaser)
Street Address of Purchaser
(City of Purchaser)	(State)	(Zip Code)	Signature of Purchaser			Date

PAPERWORK REDUCTION ACT STATEMENT

A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork Reduction Act of 1995 unless the information collection has a currently valid Office of Management and Budget (OMB) Control Number. The approved OMB Control Number for this information collection is 05XX-XXX. Without this approval, we could not conduct this (survey or information collection). Public reporting for this information collection is estimated to be approximately XX (minutes or hours) per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information collection. All responses to this information collection are (voluntary or mandatory or required to obtain benefits). Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to the U.S. Forest Service email address SM.FS.InfoCollect@usda.gov and include the OMB Control Number in the subject line.

NONDISCRIMINATION STATEMENT

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.

USDA is an equal opportunity provider, employer, and lender.

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