Information Collection

30 CFR 250, Subparts A, D, E, H, P - actual APD & Supplemental APD

IC 210271 under ICR 201402-1014-003 · OMB 1014-0025.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0025 can be found here:

Documents and Forms

Document Name Document Type
eWell_Form-123_screens 2013.pdf Other-actual screen shots from eWell
eWell_Form-123S_screens 2013.pdf Other-actual screen shots from eWell
PRA Statement for eWell.docx Other-Revised PRA Statement for eWel
BSEE-0123 Application for Permit to Drill (APD) Form 0123 exp 2017 for APD IC.xlsx www.bsee.gov/About-BSEE/Procurement-Business-Opportunities/BSEE-OCS-Operation-Forms/BSEE-OCS-Operation-Forms/ Form
BSEE-0123S Supplemental APD Information Sheet (Casing Design) Form 0123s for APD 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

View Information Collection (IC)

IC Title:	30 CFR 250, Subparts A, D, E, H, P - actual APD & Supplemental APD	Agency IC Tracking Number:	2014 - APDs

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 30 CFR 250, Subparts A, D, E,

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-123_screens 2013.pdf		Yes	Yes	Fillable Fileable
Other-actual screen shots from eWell			eWell_Form-123S_screens 2013.pdf		Yes	Yes	Fillable Fileable
Form	BSEE-0123	Application for Permit to Drill (APD)	Form 0123 exp 2017 for APD IC.xlsx	http://www.bsee.gov/About-BSEE/Procurement-Business-Opportunities/BSEE-OCS-Operation-Forms/BSEE-OCS-Operation-Forms/	Yes	Yes	Fillable Fileable
Form	BSEE-0123S	Supplemental APD Information Sheet (Casing Design)	Form 0123s for APD 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
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: 1,070	Number of Respondents for Small Entity: 738

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	1,070	1,070
Annual IC Time Burden (Hours)	1,070	1,070
Annual IC Cost Burden (Dollars)	862,104	862,104

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.