Information Collection

Request to Terminate Private Maintenance and Care Agreement (43 CFR 4750.4-3)

IC 182305 under ICR 201609-1004-001 · OMB 1004-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1004-0042 can be found here:

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Information Collection (IC) Details

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IC Title:	Request to Terminate Private Maintenance and Care Agreement (43 CFR 4750.4-3)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 43 CFR 4750.4-3

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title: Interior / LLM-28, Adopt a Wild Horse	FR Citation: 72 FR 67956

Number of Respondents: 75	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	75	-24	99
Annual IC Time Burden (Hours)	38	-12	50
Annual IC Cost Burden (Dollars)	0	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.