Information Collection

Bond Rider Extending Coverage of Bond (43 CFR 3809.500)

IC 45377 under ICR 202301-1004-002 · OMB 1004-0194.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3809-4 Bond Rider Extending Coverage of Bond (43 CFR 3809.500)	Form
3809-4 Form for Bond Rider Extending Covering of Bond to Assume 3809-004-Bond Rider Consent of Surety.pdf www.blm.gov/noc/st/en/business/eForms.html/	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 43 CFR 3809.500

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	3809-4	Form for Bond Rider Extending Covering of Bond to Assume Liabilities for Operations Conducted by Parties Other Than the Principal (Consent of Surety)	3809-004-Bond Rider Consent of Surety.pdf	http://www.blm.gov/noc/st/en/business/eForms.html/	Yes	Yes	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

Number of Respondents for Small Entity: 20

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	35	10	25
Annual IC Time Burden (Hours)	280	80	200
Annual IC Cost Burden (Dollars)	0	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.