Information Collection

203.74; 75; 76(d) - Redetermination

IC 232632 under ICR 202306-1014-004 · OMB 1014-0005.

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IC Title:

203.74; 75; 76(d) - Redetermination

Agency IC Tracking Number:

1014-0005 '21

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 203.74; 75; 76(d)

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: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

Number of Respondents for Small Entity: 1

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 60 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	1,600	1,600

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

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