Information Collection

30 CFR 250, Subparts A, D, E, H, P - actual APD & Supplemental APD

IC 210271 under ICR 201612-1014-002 · OMB 1014-0025.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0025 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
eWell_Form-123_screens 2013.pdf	Other-actual screen shots from eWell
eWell_Form-123S_screens 2013.pdf	Other-actual screen shots from eWell
PRA Statement for eWell.docx	Other-Revised PRA Statement for eWel
BSEE-0123 Application for Permit to Drill (APD) Form 0123 exp 2017 for APD IC.xlsx www.bsee.gov/About-BSEE/Procurement-Business-Opportunities/BSEE-OCS-Operation-Forms/BSEE-OCS-Operation-Forms/	Form
BSEE-0123S Supplemental APD Information Sheet (Casing Design) Form 0123s for APD ICR exp 2017.xlsx www.bsee.gov/About-BSEE/Procurement-Business-Opportunities/BSEE-OCS-Operation-Forms/BSEE-OCS-Operation-Forms/	Form

IC Title:

30 CFR 250, Subparts A, D, E, H, P - actual APD & Supplemental APD

Agency IC Tracking Number:

2014 - APDs

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 30 CFR 250, Subparts A, D, E,

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-actual screen shots from eWell			eWell_Form-123_screens 2013.pdf		Yes	Yes	Fillable Fileable
Other-actual screen shots from eWell			eWell_Form-123S_screens 2013.pdf		Yes	Yes	Fillable Fileable
Form	BSEE-0123	Application for Permit to Drill (APD)	Form 0123 exp 2017 for APD IC.xlsx	http://www.bsee.gov/About-BSEE/Procurement-Business-Opportunities/BSEE-OCS-Operation-Forms/BSEE-OCS-Operation-Forms/	Yes	Yes	Fillable Fileable
Form	BSEE-0123S	Supplemental APD Information Sheet (Casing Design)	Form 0123s for APD ICR exp 2017.xlsx	http://www.bsee.gov/About-BSEE/Procurement-Business-Opportunities/BSEE-OCS-Operation-Forms/BSEE-OCS-Operation-Forms/	Yes	Yes	Fillable Fileable
Other-Revised PRA Statement for eWell			PRA Statement for eWell.docx		Yes	No	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,070

Number of Respondents for Small Entity: 738

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-1,070	1,070
Annual IC Time Burden (Hours)	-1,070	1,070
Annual IC Cost Burden (Dollars)	-862,104	862,104

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.