U.S. DEPARTMENT OF AGRICULTURE
Forest Service	
RECLAMATION PERFORMANCE BOND
(Minerals Operating Plan and/or Exploration Permit, Including Geothermal)
(Reference FSM 6506)	
INSTRUCTIONS: (1) This form is authorized for use whenever a Performance Bond is required in connection with National Forest Reclamation Activity. (2) The full legal name and business address of the Principal shall be inserted in the space designated ``Principal'' on the face of this form. The bond shall be signed by an authorized person. Where such Person is signing in a representative capacity (e.g., an attorney-infact), but is not a member of the firm, partnership, or joint venture, or an officer of the corporation involved, evidence of his authority must be furnished. (3) Corporations executing the bond as sureties must be among those appearing on the Treasury Department's list of approved sureties and must be acting within the limitations set forth therein. (4) corporations executing the bond shall affix their corporate seals. Individuals shall execute the bond opposite the work ``Seal,'' and, if executed in Maine or New Hampshire, shall also affix an adhesive seal. (5) The name of each person signing this bond should be typed in the space provided.	
Principal (Legal name and business address)	Date Bond Executed	
     	     	
	Type of Organization (X Appropriate Box)	
	  Individual	
	  Partnership	
	  Joint Venture	
Surety(ies) (Name(s) and business address(es))	  Corporation	
     	State of Incorporation	
	     	
	PENAL SUM OF BOND	
	Million(s) $	Thousand(s) $	Hundred(s) $	
	     	     	     	
KNOW ALL MEN BY THESE PRESENTS, That we, the Principal and Surety(ies) hereto, are firmly bound to the United States of America (hereinafter called the Government) in the above penal sum for the payment of which we bind ourselves, and each of our heirs, executors, administrators, and successors, jointly and severally: Provided, That, where the Sureties are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum ``jointly and severally'' as well as ``severally'' only for the purpose of allowing a joint action or actions against any or all of us, and for all other purposes each Surety binds itself, jointly and severally with the Principal, for the payment of such sum only as is set forth opposite the name of such Surety, but if no limit of liability is indicated, the limit of liability shall be the full amount of the penal sum.	
SCHEDULE OF OPERATING PLANS – REGION      	
Name of
National Forest	Operating Plan
Number	Date	Amount Allocated
to Operating Plan
($)	Amount of Allocated
Restored
($)	Date
Restored	Unallocated
Balance
($) 	
     	     	     	     	     	     	     	
     	     	     	     	     	     	     	
     	     	     	     	     	     	     	
     	     	     	     	     	     	     	
     	     	     	     	     	     	     	
     	     	     	     	     	     	     	
     	     	     	     	     	     	     	
	
FS-6500-7 (5/79)	

THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas the Principal has an interest in the Operating Plans identified in Schedule of Operating Plans above; and
WHEREAS, the Principal and Surety agree that, without notice of the surety, the coverage of this bond, in addition to the present operating plans of the Principal, shall extend to and include:
1.  Any operating plan approved by the Forest Service and issued to the Principal in the Region or Forests named above, or later named in a rider, the coverage to become effective immediately upon approval by the Forest Serivce.
2.  Any operating plan hereafter approved by the Forest Service in the Region or Forests named above, to become effective immediately upon appoval by the Forest Service.
3.  Any extension of the operating plan, such coverage to continue without interruption due to expiration of teh operating plan.
4.  Any modification of an operating plan, include obligations thereunder, whether made by agreement, suspension of operations, or othersise; and
WHEREAS, the Principal and Surety hereby agree that notwithstanding the termination of any operating plan covered by this bond, the bond shall remain in full force and effect as to all remaining operating plans covered by this bond.
NOW, THEREFORE, If the Principal shall: Perform and fulfill all the reclamation provisions of all operating plans referred to in the Schedule of Operating Plans and shall also perform and fulfill all the reclamation provisions of any and all duly authorized modificaton of said operating plans that may hereafter be made, then the above obligations are to be void; otherwise to remain in full force and effect.
IN WITNESS WHEREOF, the Principal and Surety(ies) have executed this reclamation bond and have affixed theri seals on the date set forth above.	
PRINCIPAL	
Signature(s)	1.		2.		Corporate
Seal	
				
	(Seal)	(Seal)		
Name(s)
Titles
(Typed)	1.	     	2.	     		
	     	     		
				
SURETY(IES)	
Name
and
Address	     	State of Inc.	Liability Limit	Corporate
Seal	
		     	     		
Signature(s)	1.		2.			

Name(s)
Titles
(Typed)	1.	     	2.	     		
	     	     		
Bond Premium	Rate Per Thousand	Total	
	$	     	$	     	
Remarks	
     	
FS-6500-7 (5/79)