OMB 83-I Form

1105-0025 OMB 83-I_Signed_111615.pdf

Department of Justice Federal Coal Lease Review Information

OMB 83-I Form

OMB: 1105-0025

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PAPERWORK REDUCTION A C T S U B M I S S I O N
Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your agency's Paperwork
Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any additional documentation
to: Office of Information and Regulatory Affairs, Office of Management and Budget, Docket Library, Room 10102, 725 1 7th Street NW,
Washington, DC 20503.
1. A g e n c y / S u b a g e n c y o r i g i n a t i n g r e q u e s t

2. O M B c o n t r o l n u m b e r

United States Department of Justice, Antitrust Division
3. T y p e of i n f o r m a t i o n c o l l e c t i o n
a. I

I

b. I

{

(check

1105

a

b.

4 . T y p e of r e v i e w r e q u e s t e d (check

one)

a. IT'

New collection

one)

Regular

R e v i s i o n of a c u r r e n t l y a p p r o v e d c o l l e c t i o n

b. F j E m e r g e n c y - A p p r o v a l r e q u e s t e d b y :

c. m

Extension, without change, of a currently approved collection

c. j * " ! D e l e g a t e d

d. r~i

R e i n s t a t e m e n t , w i t h o u t c h a n g e , of a previously a p p r o v e d c o l l e c t i o n f o r
which approval has expired

e.
f. PI

None

_ 0025

/

/

5. S m a l l entities

R e i n s t a t e m e n t , w i t h c h a n g e , of a p r e v i o u s l y a p p r o v e d c o l l e c t i o n f o r w h i c h

W i l l this i n f o r m a t i o n c o l l e c t i o n h a v e a s i g n i f i c a n t e c o n o m i c i m p a c t o n a

a p p r o v a l has e x p i r e d

s u b s t a n t i a l n u m b e r of s m a l l e n t i t i e s ?

FjYes

171 No

E x i s t i n g c o l l e c t i o n in u s e w i t h o u t a n O M B c o n t r o l n u m b e r

3 a . Public C o m m e n t s

6. R e q u e s t e d e x p i r a t i o n d a t e
a. 1
7
1 T h r e e y e a r s f r o m a p p r o v a l date

H a s the a g e n c y r e c e i v e d p u b l i c c o m m e n t s o n this i n f o r m a t i o n c o l l e c t i o n ?
F~'Yes

b.flother

Specify.

/

171 N o

7. Title

Department of Justice Federal Coal Lease Review Information
8. A g e n c y f o r m n u m ber(s)

(if

applicable)

ATR-139, ATR-140
9, K e y w o r d s

federal; coal; lease; antitrust
10. A b s t r a c t

These forms seek information regarding a prospective coal lessee's coal reserves. The Department of Justice uses these forms to determine whether
a lease transfer in consistent with the antitrust laws.

1 1 . A f f e c t e d p u b l i c (Mark
a.

primary

with

" P " and all others

I n d i v i d u a l s or h o u s e h o l d s

d.

b. P B u s i n e s s or o t h e r f o r - p r o f i t

e.

c.

f.

Not-for-profit institutions

that apply

with

"X")

20

b. T o t a l a n n u a l r e s p o n s e s

20

coiiected electronically

b. _ _ R e q u i r e d t o o b t a i n or r e t a i n b e n e f i t s

" P " and all others

that apply

c.

%
40
0

"X")

Mandatory

14. A n n u a l r e p o r t i n g a n d r e c o r d k e e p i n g c o s t b u r d e n (in thousands

40

with

Voluntary

a. T o t a l a n n u a l i z e d c a p i t a l / s t a r t u p c o s t s

0

d. C u r r e n t O M B i n v e n t o r y
e. D i f f e r e n c e

with

Federal Government
S t a t e , Local or T r i b a l G o v e r n m e n t

1 . P e r c e n t a g e of t h e s e r e s p o n s e s
c. T o t a l a n n u a l h o u r s r e q u e s t e d

primary

a.

13. A n n u a l reporting and recordkeeping h o u r burden
a. N u m b e r of r e s p o n d e n t s

12. O b l i g a t i o n t o r e s p o n d (Mark

Farms

b. T o t a l a n n u a l c o s t s ( O & M )

o

c. T o t a l a n n u a l i z e d cost r e q u e s t e d

o

of

dollars)

0

d. C u r r e n t O M B i n v e n t o r y

o

e. D i f f e r e n c e

o

f. E x p l a n a t i o n of d i f f e r e n c e

f. E x p l a n a t i o n of d i f f e r e n c e

1. Program change

0

2. A d i u s t m e n t

o

1. P r o g r a m c h a n g e 0
2. A d i u s t m e n t

0

1 5 . P u r p o s e of i n f o r m a t i o n c o l l e c t i o n (Mark
others

that apply

with

primary

with " P " and

all

"X")

1 6 . F r e q u e n c y of r e c o r d k e e p i n g or r e p o r t i n g (check
a.

a.

Application for benefits

e.

P r o g r a m p l a n n i n g or m a n a g e m e n t

b.

Program evaluation

f.

Research

c.

General purpose statistics

g . P R e g u l a t o r y or c o m p l i a n c e

d. _ A u d i t

17. S t a t i s t i c a l m e t h o d s

Recordkeeping

o. /

b.

[~!Yes

p i No

apply)

Reporting
1. / O n o c c a s i o n

2.

Weekly

3.

4.

Quarterly

5.

Semi-annually

6.

7.

Biennially

8.

Other (describe)

18. A g e n c y c o n t a c t (person

D o e s this i n f o r m a t i o n c o l l e c t i o n e m p l o y s t a t i s t i c a l m e t h o d s ?

all that

Third party disclosure
Monthly
Annually

0

who can best answer

questions

regarding

the content

of this

submission)

Jill Ptacek
Name:

D h

. 202-307-6607

Phone.

OMB 83-1

02/04
Reset

19. Certification for Paperwork Reduction Act S u b m i s s i o n s
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR
1320.9.

Note:

The text of 5 CFR 1320.9, and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the instructions.
The certification is to be made with reference to those regulatory provisions as set forth in the instructions.

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a)

It is necessary for the proper performance of agency functions;

(b)

It avoids unnecessary duplication;

(c)

It reduces burden on small entities;

(d)

It uses plain, coherent, and unambiguous terminology that is understandable to respondents;

(e)

Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f)

It indicates the retention period for recordkeeping requirements;

(g)

It informs respondents of the information called for under 5 CFR 1320.8(b)(3);
(i)

Why the information is being collected;

(ii)

Use of information;

(iii)

Burden estimate;

(iv)

Nature of response (voluntary, required for a benefit, or mandatory);

(v)

Nature and extent of confidentiality; and

(vi)

Need to display currently valid OMB control number;

(h)

It was developed by an office that has planned and allocated resources for the efficient and effective
management and use of the information to be collected (see note in Item 19 of the instructions);

(i)

It uses effective and efficient statistical survey methodology; and

(j)

It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item below and explain the reason in Item 18 of
the Supporting Statement.

OMB 83-1

02/04


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