Information Collection

250.613(d) - Work as Performed

IC 225490 under ICR 201701-1014-001 · OMB 1014-0026.

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IC Title:

250.613(d) - Work as Performed

Agency IC Tracking Number:

1014-0026 APM '17

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.613(d)

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

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 755

Number of Respondents for Small Entity: 521

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	755	755
Annual IC Time Burden (Hours)	252	252
Annual IC Cost Burden (Dollars)	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.