Information Collection

Subpart D - 250.420(b);421(b);423(c);428(c),(d),(k);462(c),(d),(e);465(a),(b);721(g);743(a),(b),(c);744;746(e);1704(h)

IC 205437 under ICR 201301-1014-002 · OMB 1014-0028.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0028 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BSEE-0125 Subpart D - 250.420(b);421(b);423(c);428(c),(d),(k);462(c),(d),(e);465(a),(b);721(g);743(a),(b),(c);744;746(e);1704(h)	Form
eWell-Form-0125-EndOperationsRpt - screen shots.docx ewell.bsee.gov/ewell/	Other-eWell Screen Shots
eWell-Form-0133-WekkActivityRpt - screen shots.docx ewell.bsee.gov/ewell/	Other-eWell Screenshots
Ewell-Form-133S-OpenHoleDataReport - screen shots.pptx ewell.bsee.gov/ewell/	Other-eWell Screenshots
aaa - PRA Statement for eWell as of 10-6-14.docx ewell.bsee.gov/ewell/	Other-PRA Statement for eWell
BSEE-0125 End of Operations Report Form 0125 exp. 2014.xlsx www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Form
BSEE-0133 Well Activity Report (WAR) Form 0133 exp. 2014.xlsx www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Form
BSEE-0133S Open Hole Data Report (Supplement to the WAR) Form 0133s exp. 2014.xlsx www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Form

IC Title:

Subpart D - 250.420(b);421(b);423(c);428(c),(d),(k);462(c),(d),(e);465(a),(b);721(g);743(a),(b),(c);744;746(e);1704(h)

Agency IC Tracking Number:

1014-NEW AA11

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.428(c),(d),(k 30 CFR 250.462(c)(d)(e);465(a)(b) 30 CFR 250.420(b);421(b);423(c) 30 CFR 250.721(g);743(a)(b)(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	BSEE-0125	End of Operations Report	Form 0125 exp. 2014.xlsx	http://www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Yes	Yes	Fillable Fileable
Other-eWell Screen Shots			eWell-Form-0125-EndOperationsRpt - screen shots.docx	https://ewell.bsee.gov/ewell/	No		Printable Only
Form	BSEE-0133	Well Activity Report (WAR)	Form 0133 exp. 2014.xlsx	http://www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Yes	Yes	Fillable Fileable
Other-eWell Screenshots			eWell-Form-0133-WekkActivityRpt - screen shots.docx	https://ewell.bsee.gov/ewell/	No		Printable Only
Form	BSEE-0133S	Open Hole Data Report (Supplement to the WAR)	Form 0133s exp. 2014.xlsx	http://www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Yes	Yes	Fillable Fileable
Other-eWell Screenshots			Ewell-Form-133S-OpenHoleDataReport - screen shots.pptx	https://ewell.bsee.gov/ewell/	No		Printable Only
Other-PRA Statement for eWell			aaa - PRA Statement for eWell as of 10-6-14.docx	https://ewell.bsee.gov/ewell/	Yes	No	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8,721

Number of Respondents for Small Entity: 6,017

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,721	8,721
Annual IC Time Burden (Hours)	17,593	17,593
Annual IC Cost Burden (Dollars)	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.