Information Collection

Part 705 - Restriction on Financial Interests of State Employees

IC 11336 under ICR 201103-1029-002 · OMB 1029-0067.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1029-0067 can be found here:

Documents and Forms

Document Name Document Type
Form OSM 23 Part 705 - Restriction on Financial Interests of State Employees Form and Instruction
OSM 23 State Employee Statement of Employment and Financial Int Form OSM-23 2011.pdf www.osmre.gov/forms/Forms.aspx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Part 705 - Restriction on Financial Interests of State Employees	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 705

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OSM 23	State Employee Statement of Employment and Financial Interest	Form OSM-23 2011.pdf	http://www.osmre.gov/forms/Forms.aspx	Yes	No	Fillable Printable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,809	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,642	102	3,540
Annual IC Time Burden (Hours)	1,218	34	1,184
Annual IC Cost Burden (Dollars)	0	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.