Information Collection

Subparts A, C, D, E, G, H, P - Actual APD and Supplemental APD

IC 225271 under ICR 202208-1014-003 · OMB 1014-0025.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BSEE-0123 Subparts A, C, D, E, G, H, P - Actual APD and Supplemental APD	Form
eWell_Form-123_screens shots.pdf ewell.bsee.gov/ewell/controller?cmd=initlogin	Other-BSEE-0123 Screen Shots
eWell_Form-123S_screens shots.pdf ewell.bsee.gov/ewell/controller?cmd=initlogin	Other-BSEE-0123S Screen Shots
PAPERWORK REDUCTION ACT STATEMENT for eWell 2023.docx ewell.bsee.gov/ewell/	Other-PRA Statement for eWell
BSEE-0123 Application for Permit to Drill Form 0123 exp 2020.xlsx www.bsee.gov/who-we-are/working-with-us/doing-business-bsee/OCS-forms	Form
BSEE-0123S Supplemental APD Information Sheet Form 0123s exp 2020.xlsx www.bsee.gov/who-we-are/working-with-us/doing-business-bsee/OCS-forms	Form

IC Title:

Agency IC Tracking Number:

1014-0025 '23

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR Subparts A, C, D, E, G, H, P (To search for a specific CFR, visit the Code of Federal Regulations.)

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	BSEE-0123	Application for Permit to Drill	Form 0123 exp 2020.xlsx	https://www.bsee.gov/who-we-are/working-with-us/doing-business-bsee/OCS-forms	Yes	Yes	Fillable Fileable
Form	BSEE-0123S	Supplemental APD Information Sheet	Form 0123s exp 2020.xlsx	https://www.bsee.gov/who-we-are/working-with-us/doing-business-bsee/OCS-forms	Yes	Yes	Fillable Fileable
Other-BSEE-0123 Screen Shots			eWell_Form-123_screens shots.pdf	https://ewell.bsee.gov/ewell/controller?cmd=initlogin	Yes	Yes	Fillable Fileable
Other-BSEE-0123S Screen Shots			eWell_Form-123S_screens shots.pdf	https://ewell.bsee.gov/ewell/controller?cmd=initlogin	Yes	Yes	Printable Only
Other-PRA Statement for eWell			PAPERWORK REDUCTION ACT STATEMENT for eWell 2023.docx	https://ewell.bsee.gov/ewell/	Yes	No	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 122

Number of Respondents for Small Entity: 84

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	122	-68	190
Annual IC Time Burden (Hours)	122	-68	190
Annual IC Cost Burden (Dollars)	299,876	-101,594	401,470

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.