Information Collection

11a(1); 40; 41 - Form MMS-1017 - Designation of Applicant

IC 179363 under ICR 200703-1010-005 · OMB 1010-0106.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1010-0106 can be found here:

Documents and Forms

Document Name Document Type
Form 1017 11a(1); 40; 41 - Form MMS-1017 - Designation of Applicant Form
1017 Designation of Applicant Form 1017 exp 10-10.doc www.gomr.mms.gov/homepg/mmsforms/mms1017.PDF Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	11a(1); 40; 41 - Form MMS-1017 - Designation of Applicant	Agency IC Tracking Number:	omm-1010-0106 ext 07

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 253.11a(1); 40; 41

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1017	Designation of Applicant	Form 1017 exp 10-10.doc	http://www.gomr.mms.gov/homepg/mmsforms/mms1017.PDF	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 600	Number of Respondents for Small Entity: 420

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

Percentage of Respondents Reporting Electronically: 5 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	5,400	5,400
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.