Information Collection

Applications for Permit to Drill (APD/revised APD) - 250.410-418;420(a)(7);423(c)(1);428(b),(k);701-738

IC 211645 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form BSEE-0123 Applications for Permit to Drill (APD/revised APD) - 250.410-418;420(a)(7);423(c)(1);428(b),(k);701-738 Form and Instruction
eWell_Form-123_screens 2013.pdf ewell.bsee.gov/ewell/ Other-eWell Screenshots
eWell_Form-123S_screens 2013.pdf 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-0123 Application for Permit to Drill (APD) Form 0123 exp 2017 for APD IC.xlsx www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/ Form and Instruction
BSEE-0123S Supplemental APD Information Sheet Form 0123s for APD ICR exp 2017.xlsx www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/ Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Applications for Permit to Drill (APD/revised APD) - 250.410-418;420(a)(7);423(c)(1);428(b),(k);701-738	Agency IC Tracking Number:	1014-NEW AA11

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.410-418;420(a)(7) 30 CFR 250.423(c)(1);428(b),(k) 30 CFR 250.701 - 738

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BSEE-0123	Application for Permit to Drill (APD)	Form 0123 exp 2017 for APD IC.xlsx	http://www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Yes	Yes	Fillable Fileable
Other-eWell Screenshots			eWell_Form-123_screens 2013.pdf	https://ewell.bsee.gov/ewell/	Yes	No	Printable Only
Form and Instruction	BSEE-0123S	Supplemental APD Information Sheet	Form 0123s for APD ICR exp 2017.xlsx	http://www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Yes	Yes	Fillable Fileable
Other-eWell Screenshots			eWell_Form-123S_screens 2013.pdf	https://ewell.bsee.gov/ewell/	Yes	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: 1,070	Number of Respondents for Small Entity: 738

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

Percentage of Respondents Reporting Electronically: 95 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,070	1,070
Annual IC Time Burden (Hours)	48,922	48,922
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.