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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.