Information Collection

Surface Management Personal Bond Rider (43 CFR 3809.500)

IC 45378 under ICR 202301-1004-002 · OMB 1004-0194.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3809-4a Surface Management Personal Bond Rider (43 CFR 3809.500)	Form
3809-4a Surface Management Personal Bond Rider 3809-004a-Surface Management Personal Bond Rider.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	3809-4a	Surface Management Personal Bond Rider	3809-004a-Surface Management Personal Bond Rider.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: Land and Mineral Authorization Tracking System -- Interior, LLM-32

FR Citation: 56 FR 5014

Number of Respondents: 85

Number of Respondents for Small Entity: 55

Affected Public: Individuals or Households

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	85	16	69
Annual IC Time Burden (Hours)	680	128	552
Annual IC Cost Burden (Dollars)	1,700	320	1,380

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.