Information Collection

Oil & Gas Evaluation Questionnaire

IC 229573 under ICR 202406-1035-001 · OMB 1035-0005.

Documents and Forms

Document Name Document Type
Oil & Gas Questionnaire.docx itrs.ambvisualsolutions.com/Account/Login Other-Screenshot: Oil & Gas Evaluati
Preliminary System Screenshot as of 02162018.docx Screenshot of Primary Login Page IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Oil & Gas Evaluation Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screenshot: Oil & Gas Evaluation Questionnaire			Oil & Gas Questionnaire.docx	https://itrs.ambvisualsolutions.com/Account/Login	Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title: Individual Indian Money (IIM) Trust Funds â Interior, OS-02	FR Citation: 80 FR 1043

Number of Respondents: 64	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

	Requested	Previously Approved
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	192	192
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Screenshot of Primary Login Page	Preliminary System Screenshot as of 02162018.docx	02/21/2018

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