Information Collection

Variance Requests (43 CFR 3170.6)

IC 217106 under ICR 201701-1004-005 · OMB 1004-0207.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1004-0207 can be found here:

Documents and Forms

Document Name Document Type
Form 3160-5 Variance Requests (43 CFR 3170.6) Form and Instruction
3160-5 Sundry Notices and Reports on Wells Sundry Notices, Form 3160-5.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Variance Requests (43 CFR 3170.6)	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 3170.6

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3160-5	Sundry Notices and Reports on Wells	Sundry Notices, Form 3160-5.pdf		Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 100

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	800	800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.