UNITED STATES DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
WASHINGTON, D.C. 20240
http://www.blm.gov
 
January 24, 2012
 
In Reply Refer To:
1114 (420) P
 
EMS TRANSMISSION 02/02/2012
Instruction Memorandum No. 2012-057
Expires:  09/30/2013
 
To:                   All Washington Office and Field Office Officials
                        Attn:     Volunteer Coordinators
                                    Forms Managers                                   
 
From:               Assistant Director, National Landscape Conservation System and Community Partnerships                     
 
Subject:            Retirement of Certain Bureau of Land Management (BLM) Volunteer Program Forms
                                                                                                                       
Program Area:  Volunteers
 
Purpose:  This Instruction Memorandum (IM) provides formal notification that the following BLM Volunteer Program forms are now obsolete and any unused copies should be discarded:
 
Form 1114-1              Volunteer Performance Evaluation                    
 
Form 1114-2              Volunteer Identification Card
 
Form 1114-4              Individual Volunteer Services Agreement
 
Form 1114-5              Group Volunteer Services Agreement
 
Form 1114-5a             Parental Approval Form for Volunteers Under 18 Years of Age
 
Form 1114-7              Volunteer and Hosted Worker Report
 
Form 1114-9              Volunteer Appreciation Certificate
 
Form 1114-10             Volunteer Application
 
Policy/Action:  Effective immediately, BLM Forms 1114-1, 1114-2, 1114-4, 1114-5, 1114-5a,
1114-7, 1114-9, and 1114-10 are cancelled.  All BLM organizations should destroy any remaining inventory of these forms not currently in use.  (Existing forms 1114-4 and 1114-5 may be renewed for long-term volunteers).  The forms will no longer be available through the Printed
 
Materials Distribution Services at the National Operations Center nor from the BLM Internal Forms Website (Forms Central) at http://web.blm.gov/blmforms.
 
Time Frame:  This Instruction Memorandum is effective immediately.
 
Background:  Explanations for the retirement of the aforementioned forms are as follows:
  • The Department of the Interior Access Card has replaced Form 1114-2
  • BLM Volunteer Program Annual Report submissions have replaced data submitted via Form 1114-7
Budget Impact:  None. 
 
Manual/Handbooks Affected:  BLM Manual Section 1114, “Volunteers”
 
Coordination: This document was coordinated with Karen Wrenn (OC-652), BLM Electronic Forms Manager.
 
Contact:  Please address any questions or concerns regarding this IM to Bibi Booth of the Division of Education, Interpretation, and Partnerships at Bibi_Booth@blm.gov or
(202) 912-7451. 
 
 
 
Signed by:                                                                     Authenticated by:
Carl Rountree                                                                Robert M. Williams
Assistant Director, National Landscape                         Division of IRM Governance,WO-560
  Conservation System and Community Partnerships