40; 41; 43 - Form BOEM-1021- Covered Offshore Facilities

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⚠️ Notice: This information collection may be referencing outdated material.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-1021 40; 41; 43 - Form BOEM-1021- Covered Offshore Facilities Form
BOEM-1021 Covered Offshore Facilities BOEM-1021 Covered Offshore Facilities 2016.docx www.boem.gov/BOEM-OCS-Operation-Forms/ Form

Information Collection (IC) Details

IC Title:	40; 41; 43 - Form BOEM-1021- Covered Offshore Facilities	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 553.40; 41; 43

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BOEM-1021	Covered Offshore Facilities	BOEM-1021 Covered Offshore Facilities 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: 200	Number of Respondents for Small Entity: 140

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	200	200
Annual IC Time Burden (Hours)	1,200	1,200
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.