Information Collection

Nomination and Request for Payment Form for OSM Technical Training Courses

IC 11419 under ICR 201603-1029-004 · OMB 1029-0120.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1029-0120 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OSM-105 Nomination and Request for Payment Form for OSM Technical Training Courses	Form and Instruction
OSM-105 Nomination and Request for Payment Form for OSM Technica Nomination_Form - EXPIRES 4-30-2016 - EDITED VERSION (4) (2).pdf www.osmre.gov/resources/forms.shtm	Form and Instruction

IC Title:

Nomination and Request for Payment Form for OSM Technical Training Courses

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	OSM-105	Nomination and Request for Payment Form for OSM Technical Training Courses	Nomination_Form - EXPIRES 4-30-2016 - EDITED VERSION (4) (2).pdf	http://www.osmre.gov/resources/forms.shtm	Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 687

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	687	-257	944
Annual IC Time Burden (Hours)	57	-22	79
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.