Information Collection

Substitution Determination

IC 10500 under ICR 201208-1004-001 · OMB 1004-0058.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1004-0058 can be found here:

Documents and Forms

Document Name Document Type
Form 5460-17 Substitution Determination Form
5460-17 Substitution Determination Substitution Determination, Form 5460-017.pdf www.blm.gov/noc/st/en/business/eForms.html Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Substitution Determination	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 43 CFR 5424.1

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5460-17	Substitution Determination	Substitution Determination, Form 5460-017.pdf	http://www.blm.gov/noc/st/en/business/eForms.html	Yes	Yes	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	1	1
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.