Water Request

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form BIA-DWP-Irr-101 Request for Irrigation Services	Form and Instruction	Modified	Available
Form BIA-DWP-Irr-102 Request for Customer Information	Form and Instruction	New	Available
Form BIA-DWP-Irr-105 Land Classification and Designation Application	Form and Instruction	New	Available
Form BIA-DWP-Irr-102 Request for Customer Information	Form and Instruction	New	Available
Form BIA-DWP-Irr-105 Land Classification and Designation Application	Form and Instruction	New	Available
Form BIA-DWP-Irr-103 Assessment Waiver	Form and Instruction	Modified	Available
Form BIA-DWP-Irr-104 Incentive Agreement	Form and Instruction	Modified	Available
Form BIA-DWP-Irr-101 Request for Irrigation Services Form	Form and Instruction	Modified	Available
Form BIA-DWP-Irr-103 Annual Assessment Waiver Application	Form and Instruction	Modified	Available
Form BIA-DWP-Irr-104 Incentive Agreement	Form and Instruction	Modified	Available
6-25-19.Agency ICActivities; Submission to the OMB for Review and Approval; Water Request.pdf	Supplementary Document	Uploaded 2019-06-25	Available
Supporting Statement 1076-0141 2019 - FINAL.docx	Supporting Statement A	Uploaded 2019-06-17	Available
4-4-19.Agency IC Activities; Renewal of Agency Information Collection for Water Request 1076-0141.pdf	Supplementary Document	Uploaded 2019-06-10	Available
Privacy Act SORN_BIA-34.pdf	Supplementary Document	Uploaded 2012-12-18	Available
25 USC 381.pdf	Supplementary Document	Uploaded 2009-06-15	Available
Debt Collection Improvement Act.pdf	Supplementary Document	Uploaded 2009-06-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43769	Request for Irrigation Service (I)	Form and Instruction	Modified	Request for Irrigation Services
236522	Requesting Customer Information (B)	Form and Instruction	New	Request for Customer Information
236521	Land Classification / Designation (B)	Form and Instruction	New	Land Classification and Designation Application
236401	Requesting Customer Information (I)	Form and Instruction	New	Request for Customer Information
236400	Land Classification / Designation (I)	Form and Instruction	New	Land Classification and Designation Application
220757	Requesting an annual assessment waiver (B)	Form and Instruction	Modified	Assessment Waiver
220756	Negotiating an irrigation incentive lease with the BIA (B)	Form and Instruction	Modified	Incentive Agreement
220755	Establishing a carriage agreement (B)		Modified
220754	Requesting payment plans on bills (B)		Modified
220752	Installing fence on BIA property or rights-of-ways (B)		Modified
220751	Building non-government structures in BIA right-of-way (B)		Modified
220750	Request water for domestic or stock purposes (B)		Modified
220746	Requesting leaching service (B)		Modified
220745	Subdividing a farm unit (B)		Modified
220739	Request for Irrigation Service (B)	Form and Instruction	Modified	Request for Irrigation Services Form
189566	Requesting an annual assessment waiver (I)	Form and Instruction	Modified	Annual Assessment Waiver Application
189565	Negotiating an irrigation incentive lease with the BIA (I)	Form and Instruction	Modified	Incentive Agreement
189564	Establishing a carriage agreement (I)		Modified
189563	Requesting payment plans on bills (I)		Modified
189562	Installing fence on BIA property or rights-of-ways (I)		Modified
189561	Building non-government structures in BIA right-of-way (I)		Modified
189560	Request water for domestic or stock purposes (I)		Modified
189559	Requesting leaching service (I)		Modified
189558	Subdividing a farm unit (I)		Modified

ICR Details

OMB Control No: 1076-0141	ICR Reference No: 201906-1076-003
Status: Historical Active	Previous ICR Reference No: 201603-1076-002
Agency/Subagency: DOI/BIA	Agency Tracking No:
Title: Water Request
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/29/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/26/2019
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2023	36 Months From Approved	01/31/2020
Responses	35,941	0	34,906
Time Burden (Hours)	17,981	0	17,943
Cost Burden (Dollars)	0	0	0

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Abstract: Water users must provide information to BIA when they apply for water delivery and for a number of other services from BIA-operated irrigation facilities.

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Authorizing Statute(s): US Code: 31 USC 3701-3733 Name of Law: Debt Collection Act of 1996
   US Code: 25 USC 381 Name of Law: Irrigation Lands; Regulation of Use of Water
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 13311	04/04/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 29874	06/25/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 24

table that charts list of burden

IC Title	Form No.	Form Name
Building non-government structures in BIA right-of-way (B)
Building non-government structures in BIA right-of-way (I)
Establishing a carriage agreement (B)
Establishing a carriage agreement (I)
Installing fence on BIA property or rights-of-ways (B)
Installing fence on BIA property or rights-of-ways (I)
Land Classification / Designation (B)	BIA-DWP-Irr-105	Land Classification and Designation Application
Land Classification / Designation (I)	BIA-DWP-Irr-105	Land Classification and Designation Application
Negotiating an irrigation incentive lease with the BIA (B)	BIA-DWP-Irr-104	Incentive Agreement
Negotiating an irrigation incentive lease with the BIA (I)	BIA-DWP-Irr-104	Incentive Agreement
Request for Irrigation Service (B)	BIA-DWP-Irr-101	Request for Irrigation Services Form
Request for Irrigation Service (I)	BIA-DWP-Irr-101	Request for Irrigation Services
Request water for domestic or stock purposes (B)
Request water for domestic or stock purposes (I)
Requesting Customer Information (B)	BIA-DWP-Irr-102	Request for Customer Information
Requesting Customer Information (I)	BIA-DWP-Irr-102	Request for Customer Information
Requesting an annual assessment waiver (B)	BIA-DWP-Irr-103	Assessment Waiver
Requesting an annual assessment waiver (I)	BIA-DWP-Irr-103	Annual Assessment Waiver Application
Requesting leaching service (B)
Requesting leaching service (I)
Requesting payment plans on bills (B)
Requesting payment plans on bills (I)
Subdividing a farm unit (B)
Subdividing a farm unit (I)

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	35,941	34,906	0	1,092	-57	0
Annual Time Burden (Hours)	17,981	17,943	0	292	-254	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Segregation of sensitive PII is now confined to a single information collection with an appropriate Privacy Act Statement and other required language. The new Request for Customer Information form is anticipated to increase the hour and cost burden, however it is being utilized to bring the program into compliance and improve data quality. The Land Classification/Designation Application form increased the hour and cost burden because this information was previously collected without OMB approval and was not accounted for in the last renewal. We are accounting for it in the burden estimates in this renewal.

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Annual Cost to Federal Government: $236,962

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/26/2019

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