Information Collection

Applications for Permit to Drill (APD/revised APD) - 250.410-418;420(a)(7);423(c)(1);428(b),(k);701-738

IC 211645 under ICR 201607-1014-001 · OMB 1014-0028.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0028 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BSEE-0123 Applications for Permit to Drill (APD/revised APD) - 250.410-418;420(a)(7);423(c)(1);428(b),(k);701-738	Form and Instruction
eWell_Form-123_screens 2013.pdf ewell.bsee.gov/ewell/	Other-eWell Screenshots
eWell_Form-123S_screens 2013.pdf ewell.bsee.gov/ewell/	Other-eWell Screenshots
aaa - PRA Statement for eWell as of 10-6-14.docx ewell.bsee.gov/ewell/	Other-PRA Statement for eWell
BSEE-0123 Application for Permit to Drill (APD) Form 0123 exp 2017 for APD IC.xlsx www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Form and Instruction
BSEE-0123S Supplemental APD Information Sheet Form 0123s for APD ICR exp 2017.xlsx www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Form and Instruction

IC Title:

Applications for Permit to Drill (APD/revised APD) - 250.410-418;420(a)(7);423(c)(1);428(b),(k);701-738

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.410-418;420(a)(7),(b)(4) 30 CFR 250.423(c)(1);428(b),(k) 30 CFR 250.465(a)(1) 30 CFR 250.701 - 738

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	BSEE-0123	Application for Permit to Drill (APD)	Form 0123 exp 2017 for APD IC.xlsx	http://www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Yes	Yes	Fillable Fileable
Other-eWell Screenshots			eWell_Form-123_screens 2013.pdf	https://ewell.bsee.gov/ewell/	Yes	No	Printable Only
Form and Instruction	BSEE-0123S	Supplemental APD Information Sheet	Form 0123s for APD ICR exp 2017.xlsx	http://www.bsee.gov/About-BSEE/Doing-Business-with-BSEE/OCS-Operation-Forms/index/	Yes	Yes	Fillable Fileable
Other-eWell Screenshots			eWell_Form-123S_screens 2013.pdf	https://ewell.bsee.gov/ewell/	Yes	No	Printable Only
Other-PRA Statement for eWell			aaa - PRA Statement for eWell as of 10-6-14.docx	https://ewell.bsee.gov/ewell/	Yes	No	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 408

Number of Respondents for Small Entity: 282

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	408	0	408
Annual IC Time Burden (Hours)	1,632	1,632	0
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.