Information Collection

Renewal Form (State/Local/Tribal Govt.)

IC 204709 under ICR 202310-1028-004 · OMB 1028-0082.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Renewal Form (State/Local/Tribal Govt.)	Form
Permit Renewal Form 1028-0082 BB Permit Renewal 2016.docx www.pwrc.usgs.gov/BBL/homepage/renewalform.cfm	Form
Permit Renewal Form 1028-0082 BB Permit Renewal 2016.docx www.pwrc.usgs.gov/BBL/homepage/renewalform.cfm	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:

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	None	Permit Renewal Form	1028-0082 BB Permit Renewal 2016.docx	https://www.pwrc.usgs.gov/BBL/homepage/renewalform.cfm	Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	30	-10	40
Annual IC Time Burden (Hours)	2	1	1
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.