Information Collection

SHA/CCAA (Application Form 3-200-54) - Private Sector

IC 181910 under ICR 202010-1018-002 · OMB 1018-0094.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1018-0094 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3-200-54 SHA/CCAA (Application Form 3-200-54) - Private Sector	Form and Instruction
3-200-54 Enhancement of Survival Permits Associated with Safe Har FWS Form 3-200-54 Enhancement of Survival Permits SHAs-CCAAs 10072020.pdf www.fws.gov/forms	Form and Instruction
3-200-54 Enhancement of Survival Permits Associated with Safe Har FWS Form 3-200-54 Enhancement of Survival Permits SHAs-CCAAs 10072020.pdf www.fws.gov/forms	Form and Instruction

IC Title:

SHA/CCAA (Application Form 3-200-54) - Private Sector

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 50 CFR 13 and 17

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	3-200-54	Enhancement of Survival Permits Associated with Safe Harbor Agreement & Candidate Conservation Agreement with Assurances	FWS Form 3-200-54 Enhancement of Survival Permits SHAs-CCAAs 10072020.pdf	http://www.fws.gov/forms	Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title: Permits System--Inteior, FWS-21

FR Citation: 68 FR 52610

Number of Respondents: 11

Number of Respondents for Small Entity: 2

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11	-10	21
Annual IC Time Burden (Hours)	33	-30	63
Annual IC Cost Burden (Dollars)	550	-500	1,050

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.