Information Collection

30 CFR 250, Subpart D, 250.409 through 490

IC 210272 under ICR 201612-1014-002 · OMB 1014-0025.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
eWell_Form-123_screens 2013.pdf Other-eWell screen shots
eWell_Form-123S_screens 2013.pdf Other-eWell screen shots
PRA Statement for eWell.docx Other-Revised PRA Statement for eWel

Information Collection (IC) Details

View Information Collection (IC)

layout table

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-eWell screen shots eWell_Form-123_screens 2013.pdf Yes Yes Fillable Fileable
Other-eWell screen shots eWell_Form-123S_screens 2013.pdf Yes Yes Fillable Fileable
Other-Revised PRA Statement for eWell PRA Statement for eWell.docx Yes No Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 0 -8,417 0 8,417
Annual IC Time Burden (Hours) 0 0 0 -40,032 0 40,032
Annual IC Cost Burden (Dollars) 0 0 0 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.