Information Collection

Designation of Designee

IC 10806 under ICR 201105-1012-003 · OMB 1012-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1012-0008 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4425 Designation Form for Royalty Payment Responsibility Designation of Designee	Form and Instruction
4425 Designation Form for Royalty Payment Responsibility 0008 Form 4425 and instr 101111.pdf	Form and Instruction

IC Title:

Designation of Designee

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 1218.52(a), (c), and (d)

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 and Instruction	4425	Designation Form for Royalty Payment Responsibility	0008 Form 4425 and instr 101111.pdf	N:\PAO\Shared\REGS\ICRs\0008 (0107) -- Form 4425 Designee\0008 2011 renewal\0008 30-day FRN	Yes	Yes	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,600

Number of Respondents for Small Entity: 800

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,600	-12	1,612
Annual IC Time Burden (Hours)	1,200	-19	1,219
Annual IC Cost Burden (Dollars)	0	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.