Sundry Notices and Reports on Wells / Well Stimulation / Variance Request (43 CFR 3162.3-3)

Oil and Gas Well Stimulation, Including Hydraulic Fracturing, on Federal and Indian Lands (43 CFR Part 3160)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1004-0203 can be found here:

Documents and Forms

Document Name Document Type
Form 3160-5 Sundry Notices and Reports on Wells / Well Stimulation / Variance Request (43 CFR 3162.3-3) Form and Instruction
3160-5 Sundry Notices and Reports on Wells BLM_3160-5_3-2012.pdf www.blm.gov/blmforms/Forms/index.htm Form and Instruction

Information Collection (IC) Details

IC Title:	Sundry Notices and Reports on Wells / Well Stimulation / Variance Request (43 CFR 3162.3-3)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 43 CFR 3162.3-3

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3160-5	Sundry Notices and Reports on Wells	BLM_3160-5_3-2012.pdf	http://www.blm.gov/blmforms/Forms/index.htm	Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 170	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	170	170
Annual IC Time Burden (Hours)	1,360	1,360
Annual IC Cost Burden (Dollars)	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.