EIA-851Q Domestic Uranium Production Report (Quarterly)

U.S. Department of Energy
U.S. Energy Information Administration
Washington, DC 20585
Form EIA-851Q
Domestic Uranium Production Report (Quarterly)
This report is mandatory under 15 U.S.C. §772 (b). Failure to comply may result
in criminal fines, civil penalties and other sanctions as provided by law. For further
information concerning sanctions and data protections see the provision on
sanctions and the provision concerning the confidentiality of information in the
instructions. Title 18 U.S.C. §1001 makes it a criminal offense for any person
to knowingly and willingly make to any Agency or Department of the United
States any false, fictitious, or fraudulent statements as to any matter within
its jurisdiction.
Company Name:
Company Address:
Company City:
Company State:
Company Zip Code:
Parent Company Name:
Parent Company Street Address:
Parent Company City:
Parent Company State:
Parent Company Zip Code:

Month 1
Month 2
Month 3
Total =

ITEM 3: PRODUCTION SOURCE
Mine name(s)

REPORTING BURDEN: Public reporting burden for this collection of information is estimated to
average 1 hour per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to the U.S. Energy Information
Administration, Survey Development and Statistical Integration, EI-21, Forrestal Building, 1000
Independence Avenue S.W., Washington, D.C. 20585-0670; and to the Office of Information and
Regulatory Affairs, Office of Management and Budget, Washington, D.C. 20503. A person is not
required to respond to the collection of information unless the form displays a valid OMB number.

RESPONDENT AND CONTACT IDENTIFICATION
Preparer Name:
Preparer Title:
Preparer Company Name:
Preparer Address:
Preparer City:
Preparer State:
Preparer Zip Code:
Preparer Phone #:
Preparer Fax #:
Preparer E-mail Address:
Supervisor Name:
Supervisor Title:
Supervisor Company Name:
Supervisor Address:
Supervisor City:
Supervisor State:
Supervisor Zip Code:
Supervisor Phone #:
Supervisor Fax #:
Supervisor E-mail Address:

ITEM 1: FACILITY INFORMATION
Name:
County:
State:
Owner:
Type:
Rated Capacity:
Operating Status:
ITEM 2: PRODUCTION

OMB No. 1905-0160
Expiration Date: xx/xx/xxxx
Burden: 1 hour

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CONFIDENTIALITY OF INFORMATION: The ‘Respondent Identification’
(Company Name), ‘Item 1: Facility Information’, and production data reported on
Form EIA-851Q are considered public information and may be released in
company identifiable form. Additional information reported on this form may be
protected and may not be disclosed to the public to the extent that it satisfies the
criteria for exemption under the Freedom of Information Act (FOIA), 5 U.S.C.
552, the Department of Energy (DOE) regulations, 10 CFR 1004, implementing
the FOIA, and the Trade Secrets Act, 18 U.S.C. 1905.
The Federal Energy Administration Act requires EIA to provide company-specific
data to other Federal agencies when requested for official use. The information
reported on this form may also be made available, upon request, to another
component of the Department of Energy (DOE); to any Committee of Congress,
0.0 the Government Accountability Office, or other Federal agencies authorized by
law to receive such information. A court of competent jurisdiction may obtain this
information in response to an order. The information may be used for any nonstatistical purposes such as administrative, regulatory, law enforcement, or
adjudicatory purposes.
Data protection methods are applied to the statistical information reported on
Forms EIA-851Q, except for production data.

Other type:

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