Information Collection

Application - Rehabilitation (govt)

IC 180840 under ICR 201402-1018-004 · OMB 1018-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1018-0022 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3-200-10b Application - Rehabilitation (govt)	Form and Instruction
3-200-10b Federal Fish and Wildlife Permit Application Form 3-200-10b.REHAB.2-11-2014 final.pdf www.fws.gov/forms/3-200-10b.pdf	Form and Instruction
3-200-10b REHAB fact sheet.2-20-2014 final.pdf Fact Sheet	IC Document

IC Title:

Application - Rehabilitation (govt)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 50 CFR 21

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 and Instruction	3-200-10b	Federal Fish and Wildlife Permit Application Form	3-200-10b.REHAB.2-11-2014 final.pdf	http://www.fws.gov/forms/3-200-10b.pdf	Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title: Permits System - Interior, FWS-21

FR Citation: 68 FR 52610

Number of Respondents: 5

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fact Sheet	3-200-10b REHAB fact sheet.2-20-2014 final.pdf	02/23/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.