Electrical Power Service Application, 25 CFR 175

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Documents and Forms

Document Name Document Type
Electrical Power Service Application, 25 CFR 175 Form and Instruction
Electric Service Application Elec Application Form.doc Form and Instruction

Information Collection (IC) Details

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IC Title:	Electrical Power Service Application, 25 CFR 175	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 175

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Electric Service Application	Elec Application Form.doc		No		Paper Only

Line of Business: Energy

Subfunction: Energy Supply

Privacy Act System of Records
Title: BIA-26--Indian Electric Power Utilities	FR Citation: 52 FR 43401

Number of Respondents: 3,000	Number of Respondents for Small Entity: 3,000

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	1,500	1,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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