Information Collection

10-404 Backcountry/Wilderness Use Permit Application (Individuals)

IC 11064 under ICR 202006-1024-004 · OMB 1024-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0022 can be found here:

Documents and Forms

Document Name Document Type
Form 10-404 10-404 Backcountry/Wilderness Use Permit Application (Individuals) Form and Instruction
10-404 Backcountry/Wilderness Use Permit Application 10-404 Backcountry-Wilderness Use Permit Application 6-26-2020.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	10-404 Backcountry/Wilderness Use Permit Application (Individuals)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 1.5, 1.6, and 2.10

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10-404	Backcountry/Wilderness Use Permit Application	10-404 Backcountry-Wilderness Use Permit Application 6-26-2020.docx		No		Paper Only

Line of Business: Natural Resources

Subfunction: Recreational Resource Management and Tourism

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 188,319	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	188,319	180	15,211	172,928
Annual IC Time Burden (Hours)	25,109	24	2,028	23,057
Annual IC Cost Burden (Dollars)	0	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.