30 CFR 250, Subpart E; 250.513 thru 526

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⚠️ Notice: This information collection may be referencing outdated material.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 shots from eWell
PRA Statement for eWell.docx Other-Revised PRA Statement for eWel

Information Collection (IC) Details

IC Title:	30 CFR 250, Subpart E; 250.513 thru 526	Agency IC Tracking Number:	2014-APMs

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.513 thru 526

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-actual screen shots 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

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,029	Number of Respondents for Small Entity: 710

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	1,029	1,029
Annual IC Time Burden (Hours)	529	529
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.