Information Collection

10-404 Backcountry/Wilderness Use Permit Application (Individuals)

IC 11064 under ICR 202306-1024-003 · OMB 1024-0022.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-404 10-404 Backcountry/Wilderness Use Permit Application (Individuals)	Form and Instruction
10-404 Backcountry/Wilderness Use Permit Application 10-404 Backcountry-Wilderness Use Permit Application.08042023.pdf	Form and Instruction

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: 36 CFR 1.5, 1.6, and 2.10

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 and Instruction	10-404	Backcountry/Wilderness Use Permit Application	10-404 Backcountry-Wilderness Use Permit Application.08042023.pdf		No		Paper Only

Line of Business: Natural Resources

Subfunction: Recreational Resource Management and Tourism

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 222,030

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	222,030	33,711	188,319
Annual IC Time Burden (Hours)	29,604	4,495	25,109
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.