Information Collection

165-166; 123 - Right-of-use and Easement (State Leases)

IC 179157 under ICR 201302-1010-003 · OMB 1010-0114.

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Information Collection (IC) Details

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IC Title:	165-166; 123 - Right-of-use and Easement (State Leases)	Agency IC Tracking Number:	1010-0114-10

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 550.123, 165-166

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records
Title:	FR Citation:

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

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1	0	1
Annual IC Time Burden (Hours)	5	0	5
Annual IC Cost Burden (Dollars)	2,742	173	2,569

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