**Sample Formats for Petitioner Submissions**

**Table of Contents**

**of**

**Samples**

Sample A Letter of Intent

Sample B Future Submissions

Sample C Materials Previously Submitted, Identified On Preliminary
Inventory, Not Certified by Members of Governing Body

Sample D Certification of Membership List, Separately Certified by
Members of Governing Body

Sample E Address Change, Notified by Members of Governing Body

Sample F Change of Leadership, Notified by Members of Governing Body

Sample G Request from the Governing Body for Copies from Its Own
Documented Petition

Sample H Letter of Introduction from the Governing Body of a Petitioning
Group

Sample I Letter Requesting Second Technical Assistance Review

Sample J Letter Requesting to Be Placed on "Ready, Waiting for Active
Consideration" List

Sample K Group's Name Change, Notified by Members of Governing Body

**\[Sample A\]**

Letter of Intent

\[FOR LETTER OF INTENT\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

The \[NAME OF PETITIONING GROUP\] is writing to express its intention to
submit a documented petition for the Federal acknowledgment process
under Title 25, Code of Federal Regulations, Part 83 (25 CFR Part 83),
*Procedures for Establishing That an American Indian Group Exists as an
Indian Tribe.* This letter of intent is filed in advance of our group\'s
documented petition.

Further, this letter of intent is signed by the members of the governing
body of the \[NAME OF THE PETITIONING GROUP\] and submitted to the
Assistant Secretary - Indian Affairs. At a meeting of the \[NAME OF THE
PETITIONING GROUP\] on \[DATE\], the undersigned elected to pursue
Federal acknowledgment under 25 CFR Part 83.

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample B\]**

Certification of Later Submissions

\[FOR FUTURE SUBMISSIONS\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

This letter certifies that the accompanying petition for Federal
acknowledgment under Title 25, Code of Federal Regulations, Part 83,
*Procedures for Establishing That an American Indian Group Exists as an
Indian Tribe* (25 CFR Part 83)*,* is the official documented petition of
the \[NAME OF PETITIONING GROUP\].

This certification is signed by members of the group\'s governing body
of the \[NAME OF PETITIONING GROUP\] and submitted to the Assistant
Secretary - Indian Affairs in response to all of the criteria under 25
CFR Part 83.

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample C\]**

Certification of materials previously submitted (identified on
preliminary inventory, but not previously certified by all members of
governing body)

\[FOR MATERIALS PREVIOUSLY SUBMITTED, IDENTIFIED ON PRELIMINARY
INVENTORY, NOT CERTIFIED BY MEMBERS OF GOVERNING BODY\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

This letter is to certify that the \[NAME OF PETITIONING GROUP\]
submitted materials to the Office of Federal Acknowledgment on \[DATE OF
SUBMISSION\]. These materials are to be considered our submission of the
documented petition for Federal acknowledgment under Title 25, Code of
Federal Regulations, Part 83, *Procedures for Establishing That an
American Indian Group Exists as an Indian Tribe* (25 CFR Part 83).

That partial submission contains data of and for the \[NAME OF
PETITIONING GROUP\].

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample D\]**

Separate certification of membership list by all members of governing
body

\[CERTIFICATION OF MEMBERSHIP LIST, SEPARATELY CERTIFIED BY MEMBERS OF
GOVERNING BODY\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

We, the members of the governing body of \[NAME OF PETITIONING GROUP\],
through this letter, certify the current membership of \[NAME OF
PETITIONING GROUP\], as of \[DATE OF MEMBERSHIP LIST\]. We submit this
current membership list to the Assistant Secretary - Indian Affairs
through the Office of Federal Acknowledgment as part of the documented
petition for Federal acknowledgment under Title 25, Code of Federal
Regulations, Part 83, *Procedures for Establishing That an American
Indian Group Exists as an Indian Tribe* (25 CFR Part 83).

This submission contains the complete, current membership list of the
\[NAME OF PETITIONING GROUP\] as required under 25 CFR Part 83. Section
83.7 requires each member's full name (including maiden name), date of
birth, and current residential address.

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample E\]**

Notification of address change, certified by all members of governing
body

\[ADDRESS CHANGE, NOTIFIED BY MEMBERS OF GOVERNING BODY\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

We, the members of the governing body of \[NAME OF PETITIONING GROUP\],
through this letter, notify the Office of Federal Acknowledgment of our
change of address. The new address is listed as follows:

\[NAME OF PETITIONING GROUP\]

Address

Town, State, Zip Code

Please update your records to reflect this change in address.

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample F\]**

Notification of change of leadership, certified by all members of
governing body

\[CHANGE OF LEADERSHIP, NOTIFIED BY MEMBERS OF GOVERNING BODY\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

We, the members of the governing body of \[NAME OF PETITIONING GROUP\],
through this letter, notify you that the current officials of \[NAME OF
PETITIONING GROUP\] were selected on \[DATE OF ELECTION\]. We submit to
the Office of Federal Acknowledgment the names and titles of the newly
selected officials, as follows:

Please place this letter in the administrative correspondence file for
the \[NAME OF PETITIONING GROUP\], Petition #\[ \].

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample G\]**

Request from governing body for photocopies of its own documented
petition

\[REQUEST FROM THE GOVERNING BODY FOR COPIES FROM ITS OWN DOCUMENTED
PETITION\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

We, the members of the governing body of \[NAME OF PETITIONING GROUP\],
through this letter, request a copy of the documented petition that our
group submitted previously. We request this material under the Freedom
of Information Act. We understand that the first 100 pages are free, and
that there is a \$.13 charge per page thereafter. We are willing to pay
up to \[INSERT DOLLAR LIMIT AMOUNT\] or \[ALL APPLICABLE FEES\] for this
material.

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample H\]**

Letter of introduction (of attorney, research consultant, or contact
person) from the governing body

\[LETTER OF INTRODUCTION FROM THE GOVERNING BODY OF A PETITIONING
GROUP\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

We, the members of the governing body of \[NAME OF PETITIONING GROUP\],
through this letter, would like to introduce you to \[NAME OF ATTORNEY,
RESEARCH CONSULTANT, or CONTACT PERSON\] who is (from the law
firm/consulting firm, or a member/officer/ position title) of \[NAME OF
THE LAW FIRM, CONSULTING FIRM or PETITIONING GROUP\]. Mr./Ms. \[NAME\]
is now serving as our group's \[ATTORNEY OF RECORD, ADDITIONAL COUNSEL,
RESEARCH CONSULTANT, CONTACT PERSON\] \[and replaces our former or
serves as an additional attorney/consultant/contact person\]. Please
provide copies of future correspondence to this new/additional
(attorney, consultant, contact person) of record.

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample I\]**

\[LETTER REQUESTING SECOND TECHNICAL ASSISTANCE REVIEW\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

We, the members of the governing body of \[NAME OF PETITIONING GROUP\],
through this letter, request a second technical assistance review for
petition \# \[PETITION NUMBER OF THE PETITIONING GROUP\].

Under Title 25, Code of Federal Regulations, Part 83, *Procedures for
Establishing That an American Indian Group Exists as an Indian Tribe*,
at § 83.10(c)(1):

> If the petitioner requests that the materials submitted in response to
> the technical assistance review letter be again reviewed for adequacy,
> the Assistant Secretary will provide the additional review. However,
> this additional review will not be automatic and will be conducted
> only at the request of the petitioner.

We understand that the regulations also state that "technical assistance
will be conducted in the order of receipt of documented petitions" and
that "technical assistance reviews will not have priority over active
consideration of documented petitions."

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample J\]**

Letter requesting to be placed on "Ready, Waiting for Active
Consideration" list

\[LETTER REQUESTING TO BE PLACED ON "READY, WAITING FOR ACTIVE
CONSIDERATION" LIST\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

We, the members of the governing body of \[NAME OF PETITIONING GROUP\],
through this letter, request that the Office of Federal Acknowledgment
(OFA) proceed with active consideration of our documented petition \#
\[PETITION TRACKING NUMBER\].

We understand tht the order of consideration of documented petitions
shall be determined by the date of the OFA's notification to the
petitioner that it considers that the documented petition is ready to be
placed on active consideration. We, therefore, request that the BIA
notify us of when our petition will be placed on the "Ready, Waiting for
Active Consideration" list.

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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Date

**\[Sample K\]**

\[NAME CHANGE, NOTIFIED BY MEMBERS OF THE GOVERNING BODY\]

Assistant Secretary - Indian Affairs

Attn: Office of Federal Acknowledgment

Mailstop MS-34B-SIB

1951 Constitution Avenue, NW

Washington, D.C. 20240

Dear Assistant Secretary - Indian Affairs:

We, the members of the governing body of \[NEW NAME OF PETITIONING
GROUP\], through this letter, notify the Assistant Secretary - Indian
Affairs of a name change for our group, formerly known as \[OLD NAME OF
THE PETITIONING GROUP\]. The new name is listed as follows:

> \[NEW NAME OF PETITIONING GROUP\]
>
> \[STREET ADDRESS\]
>
> \[TOWN, STATE, ZIPCODE\].

Please update your records to reflect this change in our group's name.

Sincerely,

\[NAME OF ELECTED OFFICIAL\]

\[Position title: print name\]

\[ [signature]{.underline} \] \[ [signature]{.underline} \]

\[Position title: print name\] \[Position title: print name\]

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\[Position title: print name\] \[Position title: print name\]

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Date