Information Collection

Lessee reports accidents, fires, vandalism and notifies surface owner

IC 206871 under ICR 202203-1076-001 · OMB 1076-0180.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0180 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Lessee reports accidents, fires, vandalism and notifies surface owner	Form
Spill Reporting and Remediation Form Spill_Reporting_and_Remediation_Form.rtf www.bia.gov/policy-forms/online-forms/paperwork-reduction-act	Form
Spill Reporting and Remediation Form Spill_Reporting_and_Remediation_Form.rtf www.bia.gov/policy-forms/online-forms/paperwork-reduction-act	Form

IC Title:

Lessee reports accidents, fires, vandalism and notifies surface owner

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 226.41

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	N/A	Spill Reporting and Remediation Form	Spill_Reporting_and_Remediation_Form.rtf	https://www.bia.gov/policy-forms/online-forms/paperwork-reduction-act	Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	182	182
Annual IC Time Burden (Hours)	5,096	5,096
Annual IC Cost Burden (Dollars)	0	0

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.