Information Collection

420(b)(3); 423(b)(7); 465(a), (b)(3); plus various ref in A, D, E, F, G, P, and Q - End of Operations Report

IC 228073 under ICR 201905-1014-005 · OMB 1014-0018.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0018 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BSEE-0125 420(b)(3); 423(b)(7); 465(a), (b)(3); plus various ref in A, D, E, F, G, P, and Q - End of Operations Report	Form
eWell-Form-0125-EndOperationsRpt - screen shots.docx	Other-eWell screen shots
PRA Statement for eWell.docx	Other-PRA Statement for eWell
BSEE-0125 End of Operations Report Form 0125 exp. 2017.xlsx www.bsee.gov/sites/bsee.gov/files/form-0125-exp-2017.pdf	Form

IC Title:

420(b)(3); 423(b)(7); 465(a), (b)(3); plus various ref in A, D, E, F, G, P, and Q - End of Operations Report

Agency IC Tracking Number:

1014-0018 ext'17

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.420(b)(3); 423(b)(7); 30 CFR 250.465(a), (b)(3)

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	BSEE-0125	End of Operations Report	Form 0125 exp. 2017.xlsx	https://www.bsee.gov/sites/bsee.gov/files/form-0125-exp-2017.pdf	Yes	Yes	Fillable Fileable
Other-eWell screen shots			eWell-Form-0125-EndOperationsRpt - screen shots.docx		Yes	No	Printable Only
Other-PRA Statement for eWell			PRA Statement for eWell.docx		Yes	No	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 445

Number of Respondents for Small Entity: 307

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	445	445
Annual IC Time Burden (Hours)	1,335	1,335
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.