Field Work Check-Out Report (private)

Research Permit and Reporting System Applications and Reports (36 CFR 2.1 and 2.5)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0236 can be found here:

Documents and Forms

Document Name Document Type
Form 10-741D Field Work Check-Out Report (private) Form
10-741D PERMITTEE FIELD CHECK-OUT REPORT Form 10-741D_Permittee Field Work Check-Out Report.pdf Form

Information Collection (IC) Details

IC Title:	Field Work Check-Out Report (private)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 2.1 and 2.5

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	10-741D	PERMITTEE FIELD CHECK-OUT REPORT	Form 10-741D_Permittee Field Work Check-Out Report.pdf		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 520	Number of Respondents for Small Entity: 520

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	520	440	80
Annual IC Time Burden (Hours)	87	74	13
Annual IC Cost Burden (Dollars)	0	0	0

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.