Information Collection

Refined Helium Deliveries Detail

IC 217859 under ICR 201803-1004-001 · OMB 1004-0179.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1004-0179 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3195-4 Refined Helium Deliveries Detail	Form
3195-4 refined Helium Deliveries Detail BLM Form 3195-4.docx	Form

IC Title:

Refined Helium Deliveries Detail

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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
Form	3195-4	refined Helium Deliveries Detail	BLM Form 3195-4.docx		Yes	Yes	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	160	160
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.