11a(1); 40; 41 - Form BOEM-1017 - Appointment of Designated Applicant

30 CFR 553, Oil Spill Financial Responsibility for Offshore Facilities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1010-0106 can be found here:

Documents and Forms

Document Name Document Type
Form BOEM-1017 11a(1); 40; 41 - Form BOEM-1017 - Appointment of Designated Applicant Form
BOEM-1017 Appointment of Designated Applicant BOEM-1017 Appointment of Designated Applicant 2016.docx www.boem.gov/BOEM-OCS-Operation-Forms/ Form

Information Collection (IC) Details

IC Title:	11a(1); 40; 41 - Form BOEM-1017 - Appointment of Designated Applicant	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 553.11a(1); 40; 41

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BOEM-1017	Appointment of Designated Applicant	BOEM-1017 Appointment of Designated Applicant 2016.docx	http://www.boem.gov/BOEM-OCS-Operation-Forms/	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: 420

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 5 %

	Approved	Previously Approved
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	5,400	5,400
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.