Information Collection

Measurement Equipment at FMPs (43 CFR 3175.40) + NEW FORM

IC 195838 under ICR 202006-1004-003 · OMB 1004-0210.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1004-0210 can be found here:

Documents and Forms

Document Name Document Type
Form BLM-NEW Measurement Equipment at FMPs (43 CFR 3175.40) + NEW FORM Form
BLM-NEW Equipment Application 1004-0210 Equipment Applicaiton Coversheet Form No. XXXXX (NEW) rev12282020.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Measurement Equipment at FMPs (43 CFR 3175.40) + NEW FORM	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 43 CFR 3175.40

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BLM-NEW	Equipment Application	1004-0210 Equipment Applicaiton Coversheet Form No. XXXXX (NEW) rev12282020.docx		Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 3

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3	-2	5
Annual IC Time Burden (Hours)	240	-160	400
Annual IC Cost Burden (Dollars)	60,000	-140,000	200,000

Documents for IC

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.