Information Collection

11a(1); 40; 41 - Form BOEM-1017 - Appointment of Designated Applicant

IC 179363 under ICR 202605-1010-001 · OMB 1010-0106.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BOEM-1017 Appointment of Designated Applicant 11a(1); 40; 41 - Form BOEM-1017 - Appointment of Designated Applicant	Form
BOEM-1017 Appointment of Designated Applicant BOEM-1017 Appointment of Designated Applicant_0.pdf www.boem.gov/about-boem/procurement-business-opportunities/boem-ocs-operation-forms	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 553.11a(1); 40; 41

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	BOEM-1017			https://www.boem.gov/about-boem/procurement-business-opportunities/boem-ocs-operation-forms	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 750

Number of Respondents for Small Entity: 420

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	750	750
Annual IC Time Burden (Hours)	7,500	7,500
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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