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30, CFR 250, Subpart H; 250.801 and 807
Application for Permit to Modify(APM) and supporting documentation
OMB: 1014-0026
IC ID: 210258
OMB.report
DOI/BSEE
OMB 1014-0026
ICR 201701-1014-001
IC 210258
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0026 can be found here:
2023-06-16 - Extension without change of a currently approved collection
2020-07-07 - Revision of a currently approved collection
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
Federal Enterprise Architecture Business Reference Module
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 %
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
-70
0
70
Annual IC Time Burden (Hours)
0
0
0
-19
0
19
Annual IC Cost Burden (Dollars)
0
0
0
0
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.