Information Collection

(ePermits) Form 3-2164: Worksheet for Field Application Locations

IC 247406 under ICR 202105-1018-003 · OMB 1018-0182.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1018-0182 can be found here:

Documents and Forms

Document Name Document Type
Form 3-2164 (ePermits) Form 3-2164: Worksheet for Field Application Locations Form
3-2164 Worksheet for Field Application Locations 3-2164 Worksheet for Field Application Locations 05172021.docx fwsepermits.servicenowservices.com/fws/ Form
3-2164 Worksheet for Field Application Locations 3-2164 Worksheet for Field Application Locations 05172021.docx fwsepermits.servicenowservices.com/fws/ Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	(ePermits) Form 3-2164: Worksheet for Field Application Locations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	3-2164	Worksheet for Field Application Locations	3-2164 Worksheet for Field Application Locations 05172021.docx	https://fwsepermits.servicenowservices.com/fws/	Yes	Yes	Fillable Fileable Signable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title: INTERIOR/FWS-21, Permits System	FR Citation: 68 FR 52610

Number of Respondents: 9	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9	9
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.