Information Collection

291.105-6, 108-9, 111 Submit complaint; request confidential treatment

IC 44588 under ICR 200712-1010-003 · OMB 1010-0172.

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Information Collection (IC) Details

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IC Title:	291.105-6, 108-9, 111 Submit complaint; request confidential treatment	Agency IC Tracking Number:	291.105-6, 108-9, 111

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 291.105-6, 108-9, 111

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 4

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

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	37,500	37,500

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