Information Collection

Special Purpose - Miscellaneous (indiv)

IC 180863 under ICR 200706-1018-002 · OMB 1018-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1018-0022 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3-200-10f Special Purpose - Miscellaneous (indiv)	Form and Instruction
3-200-10f Federal Fish and Wildlife Permit Application Form 3-200-10f.pdf www.fws.gov/forms/3-200-10f.pdf	Form and Instruction

IC Title:

Special Purpose - Miscellaneous (indiv)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 50 CFR 21

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3-200-10f	Federal Fish and Wildlife Permit Application Form	3-200-10f.pdf	http://www.fws.gov/forms/3-200-10f.pdf	Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title: Permits System - Interior, FWS-21

FR Citation: 68 FR 52610

Number of Respondents: 35

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	88	88
Annual IC Cost Burden (Dollars)	3,500	3,500

Documents for IC

table that charts IC Documents
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.