Information Collection

Change of Operator - Extension to Well Plugging (Application for Permit) § 29.181(a) (ePermits)

IC 255290 under ICR 202208-1018-004 · OMB 1018-0162.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FWS Form 3-2469 Change of Operator - Extension to Well Plugging (Application for Permit) § 29.181(a) (ePermits)	Form and Instruction
Form FWS Form 3-2469 Oil and Gas Operations Special Use Permit Application Change of Operator - Extension to Well Plugging (Application for Permit) § 29.181(a) (ePermits)	Form and Instruction
FWS Form 3-2469 Oil and Gas Operations Special Use Permit Application FWS Form-3-2469 Oil Gas Special Use Final 08292022.pdf fwsepermits.servicenowservices.com/fws/	Form and Instruction
FWS Form 3-2469 Oil and Gas Operations Special Use Permit Application FWS Form 3-2469 Oil Gas Special Use Final 08292022_updated 12012023.pdf fwsepermits.servicenowservices.com/fws/	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 50 CFR 29.181(a)

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 and Instruction	FWS Form 3-2469			https://fwsepermits.servicenowservices.com/fws/	Yes	Yes	Fillable Fileable Signable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records

Title: National Wildlife Refuge Special Use Permits-Interior, FWS-5

FR Citation: 73 FR 31877

Number of Respondents: 5

Number of Respondents for Small Entity: 5

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	525	525
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.

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