Information Collection

Sundry Notices and Reports on Wells / Well Stimulation / Notice of Intent Sundry (43 CFR 3162.3-3)

IC 201479 under ICR 201304-1004-001 · OMB 1004-0203.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3160-5 Sundry Notices and Reports on Wells / Well Stimulation / Notice of Intent Sundry (43 CFR 3162.3-3)	Form and Instruction
3160-5 Sundry Notices and Reports on Wells BLM_3160-5_3-2012.pdf web.blm.gov/blmforms/index.html	Form and Instruction

IC Title:

Sundry Notices and Reports on Wells / Well Stimulation / Notice of Intent Sundry (43 CFR 3162.3-3)

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 3162.3-3

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 and Instruction	3160-5	Sundry Notices and Reports on Wells	BLM_3160-5_3-2012.pdf	http://web.blm.gov/blmforms/index.html	Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 415

Number of Respondents for Small Entity: 33

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	415	415
Annual IC Time Burden (Hours)	3,320	3,320
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.