Information Collection

250.125(c) - Refund requests - Subpart A

IC 223627 under ICR 201609-1014-002 · OMB 1014-0031.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Refund request page screenshot.PNG www.data.bsee.gov/homepg/data_center/other/refundrequest/requestrefund.asp	Other-Webpage

IC Title:

Agency IC Tracking Number:

1014-AA31

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 250.125(c)

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
Other-Webpage			Refund request page screenshot.PNG	https://www.data.bsee.gov/homepg/data_center/other/refundrequest/requestrefund.asp	Yes	Yes	Fillable Fileable Signable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 138

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	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.