Information Collection

250.465(b); 466; 467; 468(b),(c); 469 - Applying for Permit to Modify and Well Records

IC 184671 under ICR 201404-1014-001 · OMB 1014-0018.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0018 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BSEE-0133 250.465(b); 466; 467; 468(b),(c); 469 - Applying for Permit to Modify and Well Records	Form
eWell-Form-0133-WekkActivityRpt - screen shots.docx	Other-eWell Screen Shot
Ewell-Form-133S-OpenHoleDataReport - screen shots.pptx	Other-eWell Screen Shot
aaa - PRA Statement for eWell as of 9-2-14..docx	Other-PRA Statement for eWell
BSEE-0133 Well Activity Report Form 0133 exp. 2014.xlsx www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Form
BSEE-0133S Bore Hole Data (Supplement to BSEE-0133) Form 0133s exp. 2014.xlsx www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Form

IC Title:

250.465(b); 466; 467; 468(b),(c); 469 - Applying for Permit to Modify and Well Records

Agency IC Tracking Number:

1014-0018 '14

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.465(b); 466; 467 30 CFR 250.468(b),(c); 469

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	BSEE-0133	Well Activity Report	Form 0133 exp. 2014.xlsx	http://www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Yes	Yes	Fillable Fileable
Form	BSEE-0133S	Bore Hole Data (Supplement to BSEE-0133)	Form 0133s exp. 2014.xlsx	http://www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Yes	Yes	Fillable Fileable
Other-eWell Screen Shot			eWell-Form-0133-WekkActivityRpt - screen shots.docx		Yes	Yes	Fillable Fileable
Other-eWell Screen Shot			Ewell-Form-133S-OpenHoleDataReport - screen shots.pptx		Yes	Yes	Fillable Fileable
Other-PRA Statement for eWell			aaa - PRA Statement for eWell as of 9-2-14..docx		Yes	No	Printable Only

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14,596

Number of Respondents for Small Entity: 10,071

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	14,596	1,486	13,110
Annual IC Time Burden (Hours)	18,822	1,579	17,243
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.