Form ONRR-4435 Administrative Appeal Bond

Form ONRR-4435 or the "Administrative Appeal Bond" is a form issued by the U.S. Department of the Interior - Office of Natural Resources Revenue.

The form was last revised in February 1, 2018 and is available for digital filing. Download an up-to-date Form ONRR-4435 in PDF-format down below or look it up on the U.S. Department of the Interior - Office of Natural Resources Revenue Forms website.

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U.S. Department of the Interior
OMB Control Number 1012-0006
OMB Approval Expires February 28, 2021
Office of Natural Resources Revenue
ADMINISTRATIVE APPEAL BOND
Form ONRR-4435
Bond No. __________________
Bond Amount $_____________________
Date Bond Executed _________________
KNOW ALL MEN BY THESE PRESENTS, That we, _____________________________ as Principal, and
________________________, a corporation duly organized and existing under the laws of the State of
______________________, having its main office at ________________________________________, as
Surety are held and firmly bound unto the United States Office of Natural Resources Revenue in the sum of
$____________________, for the payment of which sum well and truly to be made, we bind ourselves, and our
heirs, executors, administrators, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, WHEREAS, the bond is intended to secure the
payment of principal and interest due the United States Office of Natural Resources Revenue in the event that
__________________________ is unsuccessful in its administrative appeal to the Director, Office of Natural
Resources Revenue, of (Bill Number(s))_____________________________, dated ________________, or any
order (invoice) which may be substituted, if__________________ shall pay all principal and interest found to be
due under the decision on that appeal within the time required therefor, this instrument shall be of no force or
effect; otherwise, it will remain in full force and effect.
Principal
Surety
_________________________________
_________________________________
(Legal Name)
(Legal Name)
_________________________________
_________________________________
(Address)
(Address)
_________________________________
_________________________________
By_______________________________
_________________________________
Its ______________________________
_________________________________
Corporate Seal (where required)
Paperwork Reduction Act of 1995 (PRA) Statement: The PRA (44 U.S.C. 3501 et seq.) requires us to inform you that we collect
this information to allow lessees, designees, or payors to stay the effectiveness of an order or decision by posting a surety instrument.
ONRR uses the information to secure the financial interests of the public and Indian lessors during the entire administrative and
judicial appeal process. Responses are required to obtain a benefit (43 U.S.C. 1334). Proprietary information is protected in accordance
with standards established by the Federal Oil and Gas Royalty Management Act of 1982 (30 U.S.C. 1733), the Freedom of Information
Act (5 U.S.C. 552(b)(4)), and Department regulations (43 CFR 2). An 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. Public reporting burden for this
form is estimated to average 2 hours per response, including the time for reviewing instructions, gathering and maintaining data, and
completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to the Rules and
Regs Team, Office of Natural Resources Revenue, PO Box 25165, MS 64000A, Denver, CO 80225.
Form ONRR-4435 (revised 2/2018)
U.S. Department of the Interior
OMB Control Number 1012-0006
OMB Approval Expires February 28, 2021
Office of Natural Resources Revenue
ADMINISTRATIVE APPEAL BOND
Form ONRR-4435
Bond No. __________________
Bond Amount $_____________________
Date Bond Executed _________________
KNOW ALL MEN BY THESE PRESENTS, That we, _____________________________ as Principal, and
________________________, a corporation duly organized and existing under the laws of the State of
______________________, having its main office at ________________________________________, as
Surety are held and firmly bound unto the United States Office of Natural Resources Revenue in the sum of
$____________________, for the payment of which sum well and truly to be made, we bind ourselves, and our
heirs, executors, administrators, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, WHEREAS, the bond is intended to secure the
payment of principal and interest due the United States Office of Natural Resources Revenue in the event that
__________________________ is unsuccessful in its administrative appeal to the Director, Office of Natural
Resources Revenue, of (Bill Number(s))_____________________________, dated ________________, or any
order (invoice) which may be substituted, if__________________ shall pay all principal and interest found to be
due under the decision on that appeal within the time required therefor, this instrument shall be of no force or
effect; otherwise, it will remain in full force and effect.
Principal
Surety
_________________________________
_________________________________
(Legal Name)
(Legal Name)
_________________________________
_________________________________
(Address)
(Address)
_________________________________
_________________________________
By_______________________________
_________________________________
Its ______________________________
_________________________________
Corporate Seal (where required)
Paperwork Reduction Act of 1995 (PRA) Statement: The PRA (44 U.S.C. 3501 et seq.) requires us to inform you that we collect
this information to allow lessees, designees, or payors to stay the effectiveness of an order or decision by posting a surety instrument.
ONRR uses the information to secure the financial interests of the public and Indian lessors during the entire administrative and
judicial appeal process. Responses are required to obtain a benefit (43 U.S.C. 1334). Proprietary information is protected in accordance
with standards established by the Federal Oil and Gas Royalty Management Act of 1982 (30 U.S.C. 1733), the Freedom of Information
Act (5 U.S.C. 552(b)(4)), and Department regulations (43 CFR 2). An 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. Public reporting burden for this
form is estimated to average 2 hours per response, including the time for reviewing instructions, gathering and maintaining data, and
completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to the Rules and
Regs Team, Office of Natural Resources Revenue, PO Box 25165, MS 64000A, Denver, CO 80225.
Form ONRR-4435 (revised 2/2018)

Download Form ONRR-4435 Administrative Appeal Bond

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