Information Collection

250.168, 171, 172, 174, 175, 177, 180(b), (d) - Request SOO or SOP

IC 227495 under ICR 201701-1014-004 · OMB 1014-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0022 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

250.168, 171, 172, 174, 175, 177, 180(b), (d) - Request SOO or SOP

Agency IC Tracking Number:

1014-0022 '17

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 250.168, 171, 172, 174, 175, 30 CFR 250.177, 180(b), (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: 105

Number of Respondents for Small Entity: 72

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	105	105
Annual IC Time Burden (Hours)	1,155	1,155
Annual IC Cost Burden (Dollars)	222,915	222,915

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.