Information Collection

Designation of Designee

IC 10806 under ICR 202402-1012-001 · OMB 1012-0008.

Documents and Forms

Document Name Document Type
Form ONRR-4425 Designation of Designee Form and Instruction
ONRR-4425 Designation Form for Payment Responsibility 4425_03.12.2024cc.docx www.onrr.gov/document/4425.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Designation of Designee	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 1218.52(a), (c), and (d)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ONRR-4425	Designation Form for Payment Responsibility	4425_03.12.2024cc.docx	https://www.onrr.gov/document/4425.pdf	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

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: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.