Information Collection

Conservation Agreement (Non-form Format) - Individuals

IC 255391 under ICR 202208-1018-005 · OMB 1018-0094.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1018-0094 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Neighboring Landowner Agreement Template.docx Neighboring Landowner Agreement Template	IC Document
Neighboring Landowner Agreement Template.docx Neighboring Landowner Agreement Template	IC Document

IC Title:

Conservation Agreement (Non-form Format) - Individuals

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 13 and 17

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

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title: Permits System--Interior, FWS-21

FR Citation: 68 FR 52610

Number of Respondents: 5

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	6,500	6,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Neighboring Landowner Agreement Template	Neighboring Landowner Agreement Template.docx	09/09/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.