Information Collection

Part 705 - Restriction on Financial Interests of State Employees

IC 11336 under ICR 202002-1029-003 · OMB 1029-0067.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1029-0067 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OSM 23 Part 705 - Restriction on Financial Interests of State Employees	Form and Instruction
OSM 23 State Employee Statement of Employment and Financial Int OSM-23.2020.pdf www.osmre.gov/resources/forms.shtm	Form and Instruction

IC Title:

Part 705 - Restriction on Financial Interests of State Employees

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 705

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 and Instruction	OSM 23	State Employee Statement of Employment and Financial Interest	OSM-23.2020.pdf	http://www.osmre.gov/resources/forms.shtm	Yes	No	Fillable Printable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,220

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,464	-552	5,016
Annual IC Time Burden (Hours)	382	-46	428
Annual IC Cost Burden (Dollars)	0	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.