Information Collection

Subparts D, E, F, G, H, P, Q - APM Application

IC 225480 under ICR 202208-1014-006 · OMB 1014-0026.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
eWell_Form-124_screens shots 2023.pdf ewell.bsee.gov/ewell/	Other-Screen Shots
PAPERWORK REDUCTION ACT STATEMENT for eWell 2023.docx ewell.bsee.gov/ewell/	Other-PRA Statement in eWell
BSEE Form-0124 Application for Permit to Modify (APM) Form 0124 for APM ICR 2023.xlsx ewell.bsee.gov/ewell/	Form and Instruction

IC Title:

Agency IC Tracking Number:

1014-0026 APM '23

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR Subparts D, E, F, G, H, P, Q (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
Other-Screen Shots			eWell_Form-124_screens shots 2023.pdf	https://ewell.bsee.gov/ewell/	Yes	Yes	Fillable Fileable
Other-PRA Statement in eWell			PAPERWORK REDUCTION ACT STATEMENT for eWell 2023.docx	https://ewell.bsee.gov/ewell/	No		Printable Only
Form and Instruction	BSEE Form-0124	Application for Permit to Modify (APM)	Form 0124 for APM ICR 2023.xlsx	https://ewell.bsee.gov/ewell/	Yes	Yes	Fillable Fileable Signable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,718

Number of Respondents for Small Entity: 1,185

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	1,718	-790	2,508
Annual IC Time Burden (Hours)	1,718	-790	2,508
Annual IC Cost Burden (Dollars)	249,110	-64,390	313,500

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.