Information Collection

30 CFR 250, Subpart H, 250.807

IC 210274 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⚠️ Notice: This information collection may be referencing outdated material.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-eWell
eWell_Form-123S_screens 2013.pdf Other-eWell
PRA Statement for eWell.docx Other-Revised PRA Statement for eWel

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	30 CFR 250, Subpart H, 250.807	Agency IC Tracking Number:	2014 - APDs

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.807

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-eWell	eWell_Form-123_screens 2013.pdf	Yes	Yes	Fillable Fileable
Other-eWell	eWell_Form-123S_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	Number of Respondents for Small Entity: 0

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	1
Annual IC Time Burden (Hours)	4	4
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.