Information Collection

250.1151 Form MMS-128

IC 46343 under ICR 200612-1010-001 · OMB 1010-0041.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1010-0041 can be found here:

Documents and Forms

Document Name Document Type
Form 128 250.1151 Form MMS-128 Form
128 Semiannual Well Test Report Form 128 exp 8-08.doc www.gomr.mms.gov/homepg/mmsforms/FormMMS-128.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	250.1151 Form MMS-128	Agency IC Tracking Number:	OMM-1010-0041 re AD12

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.1151

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	128	Semiannual Well Test Report	Form 128 exp 8-08.doc	http://www.gomr.mms.gov/homepg/mmsforms/FormMMS-128.pdf	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 130	Number of Respondents for Small Entity: 91

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 25 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	13,600	13,600
Annual IC Time Burden (Hours)	1,336	1,336
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.