Information Collection

11a(1); 40; 41 - Form BOEM-1017 - Appointment of Designated Applicant

IC 179363 under ICR 202207-1010-001 · OMB 1010-0106.

Documents and Forms

Document Name Document Type
Form BOEM-1017 11a(1); 40; 41 - Form BOEM-1017 - Appointment of Designated Applicant Form
BOEM-1017 Appointment of Designated Applicant BOEM-1017 Appointment of Designated Applicant_updated 10.08.2019.pdf www.boem.gov/BOEM-OCS-Operation-Forms/ Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	11a(1); 40; 41 - Form BOEM-1017 - Appointment of Designated Applicant	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 553.11a(1); 40; 41

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BOEM-1017	Appointment of Designated Applicant	BOEM-1017 Appointment of Designated Applicant_updated 10.08.2019.pdf	http://www.boem.gov/BOEM-OCS-Operation-Forms/	Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 750	Number of Respondents for Small Entity: 420

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	750	150	600
Annual IC Time Burden (Hours)	7,500	2,100	5,400
Annual IC Cost Burden (Dollars)	0	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.