Information Collection

Electric Emergency Incident and Disturbance Report

IC 22891 under ICR 202402-1901-002 · OMB 1901-0288.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DOE-417 Electric Emergency Incident and Disturbance Report	Form
DOE417_Form_Instructions.docx www.oe.netl.doe.gov/OE417/Account/Welcome.aspx	Instruction
DOE417_Form_Instructions.docx www.oe.netl.doe.gov/OE417/Account/Welcome.aspx	Instruction
DOE-417 Electric Emergency Incident and Disturbance Report DOE417_Form.docx www.oe.netl.doe.gov/OE417/Account/Welcome.aspx	Form
DOE-417 Electric Emergency Incident and Disturbance Report DOE417_Form.docx www.oe.netl.doe.gov/OE417/Account/Welcome.aspx	Form

IC Title:

Agency IC Tracking Number:

DOE-417

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 1320.5

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	DOE-417	Electric Emergency Incident and Disturbance Report	DOE417_Form.docx	https://www.oe.netl.doe.gov/OE417/Account/Welcome.aspx	Yes	Yes	Fillable Fileable
Instruction			DOE417_Form_Instructions.docx	https://www.oe.netl.doe.gov/OE417/Account/Welcome.aspx	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Supply

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,994

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,994	-40	3,034
Annual IC Time Burden (Hours)	5,025	-430	5,455
Annual IC Cost Burden (Dollars)	438,984	438,984	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.