Information Collection

Lessee submits request for lease modification

IC 232460 under ICR 202001-1076-003 · OMB 1076-0180.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0180 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Lessee submits request for lease modification	Form
Lease Modification Form Osage_Lease Modification Form.doc	Form

IC Title:

Lessee submits request for lease modification

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 226.7

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	N/A	Lease Modification Form	Osage_Lease Modification Form.doc		Yes	Yes	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

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