October 28, 2011
In Reply Refer To:
4120 (220) P
Instruction Memorandum No. 2012-013
Expires: 9/30/2013
To:                   All Field Officials
From:               Assistant Director, Renewable Resources and Planning
Subject:           Availability of Bureau of Land Management (BLM) Forms 1740-001, 1850-003, 4110-001, 4120-008, 4120-009, 4120-010, 4150-001 and 4150-002              
Program Area: Grazing Administration
Purpose:  This Instruction Memorandum (IM) announces that nine forms used for rangeland administration will not be stocked at the Printed Materials Distribution Services (PMDS). Eight of these forms will continue to be available from Forms Central. Form 4120-008, Assignment of Range Improvements, will not be stocked at the PMDS or available from Forms Central. Field offices will use the Rangeland Improvement Project System (RIPS) to generate the Assignment of Range Improvements report. 
Policy/Action:  All field offices are to discontinue use of the preprinted forms, destroy all stock of the preprinted forms, remove any of these forms from local electronic libraries, and use RIPS to generate Form 4120-008, Assignment of Range Improvements.  
The following forms will continue to be available from Forms Central at http://web.blm.gov/blmforms/:  
  • 1740-001 Project Inspection and Maintenance Record
  • 1850-003 Notice of Hearing
  • 4110-001 Location Plat
  • 4120-009 Proffer of Monetary Contribution
  • 4120-010 Range Line Agreement
  • 4150-001 Grazing Trespass Report
  • 4150-002 Certificate of Livestock Count
  • 4210-001 Alaska-Grazing Lease or Permit Application 
Timeframe:  This IM is effective immediately upon issuance. Form 4120-008 will be removed from the Forms Central webpage within 30 days after this IM has been issued. 
Budget Impact: This action will eliminate the PMDS’s cost of printing, stocking, and shipping these forms and eliminate the duplication of having Form 4120-008 available on Forms Central and RIPS.
Background: All of the forms have been available through the PMDS and Forms Central, but since these forms are available from Forms Central or RIPS, there is no longer a need to stock preprinted forms at PMDS.
Form 4120-008, Assignment of Range Improvements, has been available through the RIPS since 1988. During the transfer of grazing preference and associated use of existing range improvements, the BLM uses the information on this form to document the assignment of interest and obligation in range improvements authorized on public lands in conjunction with the transferred preference. The RIPS is the BLM recognized database for rangeland and resource improvement projects.
Manual/Handbook Sections Affected:  Grazing Management (H-4120-1). 
Coordination: This policy has been coordinated between the Division of Rangeland Resources (WO-220), RIPS User Representative (OC-580), and Bureau Forms Manager (OC-652).
Contact: Questions regarding this IM can be directed to Kimberly Hackett (WO-220) at 202-912-7216 or Lynnda Jackson (OC-580) at 303-236-8012.
Signed by:                                                                   Authenticated by:
Kit Muller                                                                     Robert M. Williams
Acting, Assistant Director                                            Division of IRM Governance,WO-560
Renewable Resources and Planning