STATEMENT OF EMPLOYMENT AND FINANCIAL INTERESTS FOR USE BY STATE EMPLOYEES -- 30 CFR PART 705

ICR 199304-1029-001

OMB: 1029-0067

Federal Form Document

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Name
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ICR Details
1029-0067 199304-1029-001
Historical Active 199003-1029-002
DOI/OSMRE
STATEMENT OF EMPLOYMENT AND FINANCIAL INTERESTS FOR USE BY STATE EMPLOYEES -- 30 CFR PART 705
Revision of a currently approved collection   No
Regular
Approved without change 06/01/1993
Retrieve Notice of Action (NOA) 04/01/1993
  Inventory as of this Action Requested Previously Approved
05/31/1996 05/31/1996 05/31/1993
2,749 0 2,777
928 0 930
0 0 0

RESPONDENTS SUPPLY INFORMATION ON EMPLOYMENT AND FINANCIAL INTERESTS. THE INFORMATION IS USED TO DETERMINE IF RESPONDENTS ARE IN COMPLIANCE WITH SECTION 517(G) OF THE SURFACE MINING CONTROL AND RECLAMATION ACT OF 1977, WHICH PLACES AN ABSOLUTE PROHIBITION ON HAVING A DIRECT OR INDIRECT FINANCIAL INTEREST IN UNDERGROUND OR SURFACE COAL MINING OPERATIONS.

None
None


No

1
IC Title Form No. Form Name
STATEMENT OF EMPLOYMENT AND FINANCIAL INTERESTS FOR USE BY STATE EMPLOYEES -- 30 CFR PART 705

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,749 2,777 0 0 -28 0
Annual Time Burden (Hours) 928 930 0 0 -2 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/01/1993


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