Information Collection

11a(1); 40; 41 - Form MMS-1016 - Designated Applicant Information

IC 10801 under ICR 201008-1010-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form MMS-1016 11a(1); 40; 41 - Form MMS-1016 - Designated Applicant Information	Form
Form 1016a PRA cover sheet 4 OSFR exp 12-13.doc www.gomr.mms.gov/homepg/mmsforms/frmindx.html	Instruction
MMS-1016 Designated Applicant Information Certification Form 1016 exp 12-13.doc www.gomr.mms.gov/homepg/mmsforms/frmindx.html	Form

IC Title:

11a(1); 40; 41 - Form MMS-1016 - Designated Applicant Information

Agency IC Tracking Number:

1010-0106 ext 10

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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

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	MMS-1016	Designated Applicant Information Certification	Form 1016 exp 12-13.doc	http://www.gomr.mms.gov/homepg/mmsforms/frmindx.html	Yes	Yes	Fillable Printable
Instruction			Form 1016a PRA cover sheet 4 OSFR exp 12-13.doc	http://www.gomr.mms.gov/homepg/mmsforms/frmindx.html	Yes	Yes	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 140

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

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.