30 CFR 250, Subparts D, E, F, H, P, Q - actual APM

Application for Permit to Modify(APM) and supporting documentation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0026 can be found here:

Documents and Forms

Document Name Document Type
eWell_Form-124_screens 2013.pdf Other-actual screen shot from eWell
PRA Statement for eWell.docx Other-Revised PRA Statement for eWel
BSEE-0124 Application for Permit to Modify (APM) Form 0124 for the APM ICR exp 2017.xlsx www.bsee.gov/About-BSEE/Procurement-Business-Opportunities/BSEE-OCS-Operation-Forms/BSEE-OCS-Operation-Forms/ Form

Information Collection (IC) Details

IC Title:	30 CFR 250, Subparts D, E, F, H, P, Q - actual APM	Agency IC Tracking Number:	2014-APMs

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 250

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-actual screen shot from eWell			eWell_Form-124_screens 2013.pdf		Yes	Yes	Fillable Fileable
Other-Revised PRA Statement for eWell			PRA Statement for eWell.docx		Yes	No	Printable Only
Form	BSEE-0124	Application for Permit to Modify (APM)	Form 0124 for the APM ICR exp 2017.xlsx	http://www.bsee.gov/About-BSEE/Procurement-Business-Opportunities/BSEE-OCS-Operation-Forms/BSEE-OCS-Operation-Forms/	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,444	Number of Respondents for Small Entity: 3,066

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

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,444	4,444
Annual IC Time Burden (Hours)	4,444	4,444
Annual IC Cost Burden (Dollars)	361,625	361,625

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.