Information Collection

Request for Replacement Animals or Refund (43 CFR 4750.4-4)

IC 182314 under ICR 202312-1004-002 · OMB 1004-0042.

Documents and Forms

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Document Name	Document Type

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IC Title:

Request for Replacement Animals or Refund (43 CFR 4750.4-4)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 43 CFR 4750.4-4

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: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title: Interior / LLM-28, Adopt a Wild Horse

FR Citation: 72 FR 67956

Number of Respondents: 12

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	Previously Approved
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	1,800	1,800

Documents for IC

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