The Indian Health Service (IHS) Buy Indian Act Indian Economic Enterprise Representation Form is a self-certification document for offerors responding to solicitations, sources sought notices, or RFIs under the Buy Indian Act (25 U.S.C. 47). It requires businesses to attest that they meet the definition of an “Indian Economic Enterprise” (HHSAR 326.601) at the time of offer, contract award, and throughout the contract performance period. The form emphasizes the need for immediate written notification to the Contracting Officer if eligibility requirements are no longer met. It also states that individual Contracting Officers may request documentation of eligibility and that successful offerors must be registered with the System for Award Management (SAM). The document warns against submitting false or misleading information, citing potential penalties under 18 U.S.C. 1001 for false information and 31 U.S.C. 3729 to 3731 and 18 U.S.C. 287 for false claims during contract performance. Offerors must indicate whether they meet the definition of an “Indian Economic Enterprise” with “Indian Ownership” and provide details such as the name of the 51% owner, certifying signature, print name, name of the Federally Recognized Tribal Entity, business name, and DUNS Number.