Information Collection

465b(3); 466; 467; 468b, c; 469 - Applying for Permit to Modify and Well Records

IC 184671 under ICR 201106-1010-001 · OMB 1010-0141.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0133 465b(3); 466; 467; 468b, c; 469 - Applying for Permit to Modify and Well Records	Form
0133 Well Activity Report (WAR) Form 0133 exp 2014.xls www.gomr.boemre.gov/homepg/forms/frmindx.html	Form
0133S Open Hole Data Report Form 0133s exp 2014.xls www.gomr.boemre.gov/homepg/forms/frmindx.html	Form

IC Title:

Agency IC Tracking Number:

OMM-1010-0141 ext 2011

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.469 30 CFR 250.465b(3); 466; 467; 468b, c

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	0133	Well Activity Report (WAR)	Form 0133 exp 2014.xls	http://www.gomr.boemre.gov/homepg/forms/frmindx.html	Yes	Yes	Fillable Printable
Form	0133S	Open Hole Data Report	Form 0133s 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: 13,110

Number of Respondents for Small Entity: 8,522

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	13,110	-14,112	27,222
Annual IC Time Burden (Hours)	17,243	-10,479	27,722
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.