Information Collection

Lessee submits applications for well drilling, treating, plugging, etc.

IC 206860 under ICR 201507-1076-001 · OMB 1076-0180.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0180 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 139 Lessee submits applications for well drilling, treating, plugging, etc.	Form
Form 139 Application to Drill or Reenter Form 139 - Permit to Drill or Reenter.docx	Form
Easement Form Osage - Easement Form.docx	Form
Notification of Well Spud Form Osage - Notification of Well Spud Form.doc	Form
Seismic Permit Osage - Seismic Permit.docx	Form

IC Title:

Lessee submits applications for well drilling, treating, plugging, etc.

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 226.34(b) 25 CFR 226.52

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form 139	Application to Drill or Reenter	Form 139 - Permit to Drill or Reenter.docx	Yes	Yes	Fillable Printable
Form	None	Easement Form	Osage - Easement Form.docx	Yes	Yes	Fillable Printable
Form	None	Notification of Well Spud Form	Osage - Notification of Well Spud Form.doc	Yes	Yes	Fillable Printable
Form	None	Seismic Permit	Osage - Seismic Permit.docx	Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 30

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	4,800	4,800
Annual IC Cost Burden (Dollars)	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.