Water Request

Forms and Documents

Document	Type	Status	Availability
Form BIA-DWP-Irr-101 Request for Irrigation Services	Form and Instruction	Unchanged	Available
Form BIA-DWP-Irr-101 Request for Irrigation Service (I)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-102 Request for Customer Information	Form and Instruction	Unchanged	Available
Form BIA-DWP-Irr-102 Requesting Customer Information (B)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-105 Land Classification and Designation Application	Form and Instruction	Unchanged	Available
Form BIA-DWP-Irr-105 Land Classification / Designation (B)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-102 Request for Customer Information	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-102 Requesting Customer Information (I)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-105 Land Classification and Designation Application	Form and Instruction	Unchanged	Available
Form BIA-DWP-Irr-105 Land Classification / Designation (I)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-103 Assessment Waiver	Form and Instruction	Unchanged	Available
Form BIA-DWP-Irr-103 Requesting an annual assessment waiver (B)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-104 Incentive Agreement	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-104 Negotiating an irrigation incentive lease with the BIA (B)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-106 Agreement for the Carriage of Water	Form and Instruction	Modified	Available
Form BIA-DWP-Irr-106 Establishing a carriage agreement (B)	Form and Instruction	Modified	Repair queued
Form BIA-DWP-Irr-101 Request for Irrigation Services Form	Form and Instruction	Unchanged	Available
Form BIA-DWP-Irr-101 Request for Irrigation Service (B)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-103 Annual Assessment Waiver Application	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-103 Requesting an annual assessment waiver (I)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-104 Incentive Agreement	Form and Instruction	Unchanged	Available
Form BIA-DWP-Irr-104 Negotiating an irrigation incentive lease with the BIA (I)	Form and Instruction	Unchanged	Repair queued
Form BIA-DWP-Irr-106 Agreement for the Carriage of Water	Form and Instruction	Modified	Repair queued
Form BIA-DWP-Irr-106 Establishing a carriage agreement (I)	Form and Instruction	Modified	Repair queued
86 FR 50737.pdf	Supplementary Document	Uploaded 2022-09-28	Repair queued
87 FR 58818.pdf	Supplementary Document	Uploaded 2022-09-28	Repair queued
IAFR001124_Supporting Statement 1076-0141 (09-06-22).docx	Supporting Statement A	Uploaded 2022-09-19	Repair queued
September 7, 2021 (86 FR 50156).pdf	Supplementary Document	Uploaded 2022-08-30	Repair queued
February 4, 2013 (78 FR 7804).pdf	Supplementary Document	Uploaded 2022-08-30	Repair queued
Privacy Act SORN_BIA-34.pdf	Supplementary Document	Uploaded 2012-12-18	Repair queued
25 USC 381.pdf	Supplementary Document	Uploaded 2009-06-15	Missing upstream
Debt Collection Improvement Act.pdf	Supplementary Document	Uploaded 2009-06-15	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
43769	Request for Irrigation Service (I)	Form and Instruction	Unchanged	Request for Irrigation Services
43769	Request for Irrigation Service (I)	Form and Instruction	Unchanged
236522	Requesting Customer Information (B)	Form and Instruction	Unchanged	Request for Customer Information
236522	Requesting Customer Information (B)	Form and Instruction	Unchanged
236521	Land Classification / Designation (B)	Form and Instruction	Unchanged	Land Classification and Designation Application
236521	Land Classification / Designation (B)	Form and Instruction	Unchanged
236401	Requesting Customer Information (I)	Form and Instruction	Unchanged	Request for Customer Information
236401	Requesting Customer Information (I)	Form and Instruction	Unchanged
236400	Land Classification / Designation (I)	Form and Instruction	Unchanged	Land Classification and Designation Application
236400	Land Classification / Designation (I)	Form and Instruction	Unchanged
220757	Requesting an annual assessment waiver (B)	Form and Instruction	Unchanged	Assessment Waiver
220757	Requesting an annual assessment waiver (B)	Form and Instruction	Unchanged
220756	Negotiating an irrigation incentive lease with the BIA (B)	Form and Instruction	Unchanged	Incentive Agreement
220756	Negotiating an irrigation incentive lease with the BIA (B)	Form and Instruction	Unchanged
220755	Establishing a carriage agreement (B)	Form and Instruction	Modified	Agreement for the Carriage of Water
220755	Establishing a carriage agreement (B)	Form and Instruction	Modified
220754	Requesting payment plans on bills (B)		Unchanged
220752	Installing fence on BIA property or rights-of-ways (B)		Unchanged
220751	Building non-government structures in BIA right-of-way (B)		Unchanged
220750	Request water for domestic or stock purposes (B)		Unchanged
220746	Requesting leaching service (B)		Unchanged
220745	Subdividing a farm unit (B)		Unchanged
220739	Request for Irrigation Service (B)	Form and Instruction	Unchanged	Request for Irrigation Services Form
220739	Request for Irrigation Service (B)	Form and Instruction	Unchanged
189566	Requesting an annual assessment waiver (I)	Form and Instruction	Unchanged	Annual Assessment Waiver Application
189566	Requesting an annual assessment waiver (I)	Form and Instruction	Unchanged
189565	Negotiating an irrigation incentive lease with the BIA (I)	Form and Instruction	Unchanged	Incentive Agreement
189565	Negotiating an irrigation incentive lease with the BIA (I)	Form and Instruction	Unchanged
189564	Establishing a carriage agreement (I)	Form and Instruction	Modified	Agreement for the Carriage of Water
189564	Establishing a carriage agreement (I)	Form and Instruction	Modified
189563	Requesting payment plans on bills (I)		Unchanged
189562	Installing fence on BIA property or rights-of-ways (I)		Unchanged
189561	Building non-government structures in BIA right-of-way (I)		Unchanged
189560	Request water for domestic or stock purposes (I)		Unchanged
189559	Requesting leaching service (I)		Unchanged
189558	Subdividing a farm unit (I)		Unchanged

ICR Details

OMB Control No: 1076-0141	ICR Reference No: 202208-1076-003
Status: Active	Previous ICR Reference No: 201906-1076-003
Agency/Subagency: DOI/BIA	Agency Tracking No: IAFR001124
Title: Water Request
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/07/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/29/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2026	36 Months From Approved	03/31/2023
Responses	35,941	0	35,941
Time Burden (Hours)	17,981	0	17,981
Cost Burden (Dollars)	0	0	0

---

Abstract: The BIA owns, operates, and maintains irrigation projects that provide a service to the end user. To properly bill for the services provided, the BIA must collect customer information to identify the individual responsible for repaying the government the costs of delivering the service; determine eligibility for waiver of fees; and determine designation of irrigable lands as assessable or non-assessable. Additional information necessary for providing the service is the location of the service delivery and the number of serviced acres. The Debt Collection Improvement Act of 1996 (DCIA) requires that certain information be collected from individuals and businesses doing business with the government. This information includes the taxpayer identification number for possible future use to recover delinquent debt. To implement the DCIA requirement

---

Authorizing Statute(s): US Code: 31 USC 3701-3733 Name of Law: Debt Collection Act of 1996
   US Code: 25 USC 381 Name of Law: Irrigation Lands; Regulation of Use of Water
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 50737	09/10/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 58818	09/28/2022
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 24

IC Title	Form No.	Form Name
Building non-government structures in BIA right-of-way (B)
Building non-government structures in BIA right-of-way (I)
Establishing a carriage agreement (B)	BIA-DWP-Irr-106	Agreement for the Carriage of Water
Establishing a carriage agreement (I)	BIA-DWP-Irr-106	Agreement for the Carriage of Water
Installing fence on BIA property or rights-of-ways (B)
Installing fence on BIA property or rights-of-ways (I)
Land Classification / Designation (B)	BIA-DWP-Irr-105	Land Classification and Designation Application
Land Classification / Designation (I)	BIA-DWP-Irr-105	Land Classification and Designation Application
Negotiating an irrigation incentive lease with the BIA (B)	BIA-DWP-Irr-104	Incentive Agreement
Negotiating an irrigation incentive lease with the BIA (I)	BIA-DWP-Irr-104	Incentive Agreement
Request for Irrigation Service (B)	BIA-DWP-Irr-101	Request for Irrigation Services Form
Request for Irrigation Service (I)	BIA-DWP-Irr-101	Request for Irrigation Services
Request water for domestic or stock purposes (B)
Request water for domestic or stock purposes (I)
Requesting Customer Information (B)	BIA-DWP-Irr-102	Request for Customer Information
Requesting Customer Information (I)	BIA-DWP-Irr-102	Request for Customer Information
Requesting an annual assessment waiver (B)	BIA-DWP-Irr-103	Assessment Waiver
Requesting an annual assessment waiver (I)	BIA-DWP-Irr-103	Annual Assessment Waiver Application
Requesting leaching service (B)
Requesting leaching service (I)
Requesting payment plans on bills (B)
Requesting payment plans on bills (I)
Subdividing a farm unit (B)
Subdividing a farm unit (I)

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	35,941	35,941	0	0	0	0
Annual Time Burden (Hours)	17,981	17,981	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $315,208

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/29/2022

---