Information Collection

30, CFR 250, Subpart H; 250.801 and 807

IC 210258 under ICR 201701-1014-001 · OMB 1014-0026.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0026 can be found here:

Documents and Forms

Document Name Document Type
eWell_Form-124_screens 2013.pdf Other-actual screen shots
PRA Statement for eWell.docx Other-Revised PRA Statement for eWel

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	30, CFR 250, Subpart H; 250.801 and 807	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.801 and 807

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-actual screen shots			eWell_Form-124_screens 2013.pdf		Yes	No	Printable Only
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: 70	Number of Respondents for Small Entity: 48

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

Percentage of Respondents Reporting Electronically: 95 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-70	70
Annual IC Time Burden (Hours)	-19	19
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.