Information Collection

408-418 - Apply for a Permit to Drill

IC 184665 under ICR 201106-1010-001 · OMB 1010-0141.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0123 408-418 - Apply for a Permit to Drill	Form
0123 Application for Permit to Drill (APD) Form 0123 exp 2014.XLS www.gomr.boemre.gov/homepg/forms/frmindx.html	Form
0123S Supplemental APD Information Sheet Form 0123s exp 2014.xls www.gomr.boemre.gov/homepg/forms/frmindx.html	Form

IC Title:

Agency IC Tracking Number:

1010-0141 for 2014

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.408-418

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	0123	Application for Permit to Drill (APD)	Form 0123 exp 2014.XLS	http://www.gomr.boemre.gov/homepg/forms/frmindx.html	Yes	Yes	Fillable Printable
Form	0123S	Supplemental APD Information Sheet	Form 0123s exp 2014.xls	http://www.gomr.boemre.gov/homepg/forms/frmindx.html	Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 502

Number of Respondents for Small Entity: 327

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	502	-899	1,401
Annual IC Time Burden (Hours)	37,375	34,571	2,804
Annual IC Cost Burden (Dollars)	728,748	-566,252	1,295,000

Documents for IC

table that charts IC Documents
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.