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.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1014-0025 can be found here:

2026-10-16 - Extension without change of a currently approved collection

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
Form BSEE-0123 Application for Permit to Drill Subparts A, C, D, E, G, H, P - Actual APD and Supplemental APD	Form
Form BSEE-0123S Supplemental APD Information Sheet 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-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
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
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-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
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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

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

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.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BSEE-0123	https://www.bsee.gov/who-we-are/working-with-us/doing-business-bsee/OCS-forms	Yes	Yes	Fillable Fileable
Form	BSEE-0123S	https://www.bsee.gov/who-we-are/working-with-us/doing-business-bsee/OCS-forms	Yes	Yes	Fillable Fileable
Other-BSEE-0123 Screen Shots		https://ewell.bsee.gov/ewell/controller?cmd=initlogin	Yes	Yes	Fillable Fileable
Other-BSEE-0123S Screen Shots		https://ewell.bsee.gov/ewell/controller?cmd=initlogin	Yes	Yes	Printable Only
Other-PRA Statement for eWell		https://ewell.bsee.gov/ewell/	Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

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
	Approved	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.

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