Information Collection

Requesting an annual assessment waiver (I)

IC 189566 under ICR 202512-1076-001 · OMB 1076-0141.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BIA-DWP-Irr-103 Annual Assessment Waiver Application Requesting an annual assessment waiver (I)	Form and Instruction
BIA-DWP-Irr-103 Annual Assessment Waiver Application BIA-DWP-Irr-103 Assessment Waiver 2019.docx www.bia.gov/policy-forms/online-forms	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 171.715 25 CFR 171.710

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 and Instruction	BIA-DWP-Irr-103			https://www.bia.gov/policy-forms/online-forms	Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Water Resource Management

Privacy Act System of Records

Title: BIA-34, National Irrigation Information Management System

FR Citation: 73 FR 40601

Number of Respondents: 123

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	123	123
Annual IC Time Burden (Hours)	123	123
Annual IC Cost Burden (Dollars)	0	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.

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