Depredation Order Report Form

DOI Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0011 can be found here:

Documents and Forms

Document Name Document Type
Form 3-2346 DO Report Form 02082019.docx Other-Report Form
Depredation Order Report Form DI-4011 Signed 02081019.pdf Request for Approval IC Document

Information Collection (IC) Details

IC Title:	Depredation Order Report Form	Agency IC Tracking Number:	2019-FWS-FT65

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Report Form			Form 3-2346 DO Report Form 02082019.docx		Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title: Permits System–Interior, FWS–21 (modification published June 4, 2008)	FR Citation: 73 FR 31877

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	600	600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	Depredation Order Report Form DI-4011 Signed 02081019.pdf	02/08/2019

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