Form 861 G 

 (Revised June 1, 1910) Notice to Grazing Applicant ana Letter of Transmlttal 



SEE OTHER SIDE FOR INSTRUCTIONS READ CAREFULLY 



Payment must "be made Tt>elore beginning of the grazing period. 



,191.. 



THE NATIONAL BANK, 



United States Depository, 



There is inclosed herewith a (1) {^f order } for 



dollars, 



drawn payable to your order, to be placed to the credit of the TREASURER OF THE 



UNITED STATES. This, deposit is on account of an application dated , 



191. .., for a permit to graze head of , head of 



, head of , upon lands of the United States within the 



National Forest, which has been approved for head 



of , head of , head of , 



the stock to be allowed in District No 



from.. ., 191..., to .. .,191.. 



(Signature of payer) 



(Post office) 

 (Permit No.) (Supervisor) 



(Name) 



Deposit on account of grazing permit, 



National Forest. 



$ 



[Reverse side Form 861 G] INFORMATION FOR PERSONS MAKING PAYMENTS 



Indicate in the space marked (1) the character of your remittance, in (2) your name, 

 and in (3) the address to which you wish the receipt sent. Failure on your part to 

 make payments in the following manner will delay business: Make payments by postal 



or express money orders or by National Bank drafts, DRAWN PAYABLE TO THE 



NATIONAL BANK. Do NOT SEND PERSONAL LOCAL CHECKS. Send payment with the 

 copy of this form furnished you by the Forest officer to The National Bank, 



INSTRUCTIONS TO FOREST OFFICERS 



Furnish this form to persons making payments for grazing permits. Enter in the 

 spaces provided the amount of the remittance, date of application, number and kind 

 of stock permit is applied for, number application is approved for, district stock will 

 be grazed upon, and period during which grazing will be allowed. Send a duplicate 

 copy to the District Forester and file a triplicate copy with the other papers in the case . 

 Do not use this form for any payments except those on account of grazing permits. 



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