Information Collection

21-24; 26-27; 30; 40-41; 43 - BOEM-1018 - Self Insurance Information

IC 179365 under ICR 201306-1010-001 · OMB 1010-0106.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1010-0106 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BOEM-1018 21-24; 26-27; 30; 40-41; 43 - BOEM-1018 - Self Insurance Information	Form
BOEM-1018 Self-Insurance Information BOEM-1018 Self Insurance Information 7-30-13.docx www.boem.gov/BOEM-OCS-Operation-Forms/	Form

IC Title:

21-24; 26-27; 30; 40-41; 43 - BOEM-1018 - Self Insurance Information

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 553.21-24; 26-27; 30; 40-41;43

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	BOEM-1018	Self-Insurance Information	BOEM-1018 Self Insurance Information 7-30-13.docx	http://www.boem.gov/BOEM-OCS-Operation-Forms/	Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 32

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	50	-25	75
Annual IC Time Burden (Hours)	50	-25	75
Annual IC Cost Burden (Dollars)	0	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.