Information Collection

Securities

IC 10841 under ICR 201105-1012-002 · OMB 1012-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1012-0006 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4435 Securities	Form
Surety Instrument Posting Instr.pdf	Instruction
4435 Administrative Appeal Bond Form 4435 Appeal Bond.pdf	Form
4436 Letter of Credit Form 4436 LOC.pdf	Form
4437 Assignment of Certificate of Deposit Form 4437 CD.pdf	Form

IC Title:

Securities

Agency IC Tracking Number:

onrr 1012-0006

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 1243.4(a)(1)

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	4435	Administrative Appeal Bond	Form 4435 Appeal Bond.pdf	N:\PAO\Shared\REGS\ICRs\0006 (0122) -- Suspension Pending Appeal and Bonding\2011 Renewal (exp. 113011)\0122 30-day\ROCIS	Yes	No	Printable Only
Form	4436	Letter of Credit	Form 4436 LOC.pdf	N:\PAO\Shared\REGS\ICRs\0006 (0122) -- Suspension Pending Appeal and Bonding\2011 Renewal (exp. 113011)\0122 30-day\ROCIS	Yes	No	Printable Only
Form	4437	Assignment of Certificate of Deposit	Form 4437 CD.pdf	N:\PAO\Shared\REGS\ICRs\0006 (0122) -- Suspension Pending Appeal and Bonding\2011 Renewal (exp. 113011)\0122 30-day\ROCIS	Yes	No	Printable Only
Instruction			Surety Instrument Posting Instr.pdf	N:\PAO\Shared\REGS\ICRs\0006 (0122) -- Suspension Pending Appeal and Bonding\2011 Renewal (exp. 113011)\0122 30-day\ROCIS	Yes	No	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 5

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	40	-100	140
Annual IC Time Burden (Hours)	80	-60	140
Annual IC Cost Burden (Dollars)	0	-250	250

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.