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Request for Extension of Royalty-Free Flaring During Subsequent Well Testing
Waste Prevention, Production Subject to Royalties, and Resource Conservation (43 CFR parts 3160 and 3170)
OMB: 1004-0211
IC ID: 219337
OMB.report
DOI/BLM
OMB 1004-0211
ICR 201712-1004-001
IC 219337
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1004-0211 can be found here:
2024-04-10 - Revision of a currently approved collection
2022-11-30 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 3160-5
Request for Extension of Royalty-Free Flaring During Subsequent Well Testing
Form and Instruction
3160-5 Sundry Notices and Reports on Wells
Sundry Notice, Form 3160-5.pdf
www.blm.gov/noc/st/en/business/eForms.html
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Request for Extension of Royalty-Free Flaring During Subsequent Well Testing
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
43 CFR 3179.104
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 Notice, Form 3160-5.pdf
http://www.blm.gov/noc/st/en/business/eForms.html
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Energy
Subfunction:
Energy Production
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5
Number of Respondents for Small Entity:
4
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
5
0
0
0
0
5
Annual IC Time Burden (Hours)
10
0
0
0
0
10
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.