Electrical Power Service Application, 25 CFR 175

OMB 1076-0021

Customers of BIA electric power facilities must provide information to BIA to obtain electric service.

The latest form for Electrical Power Service Application, 25 CFR 175 expires 2022-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Electrical Power Service Application, 25 CFR 175 Form and Instruction
86 FR 50737.pdf Supplementary Document
87 FR 58369.pdf Supplementary Document
IAFR001125__Supporting Statement A (1076-0021)__09-2022.docx Supporting Statement A
86 FR 50156.pdf Supplementary Document
79 FR 24002.pdf Supplementary Document
25 CFR 175.pdf Supplementary Document
Debt Collection Improvement Act.pdf Supplementary Document
Electrical Power Service Application, 25 CFR 175 Form and Instruction
Letter from medical services provider, 25 CFR 175

All Historical Document Collections

202208-1076-002 Approved without change	Revision of a currently approved collection	2022-09-26
201906-1076-007 Approved without change	Revision of a currently approved collection	2019-06-26
201603-1076-003 Approved without change	Extension without change of a currently approved collection	2016-03-31
201210-1076-001 Approved without change	Extension without change of a currently approved collection	2012-12-28
200904-1076-004 Approved without change	Extension without change of a currently approved collection	2009-08-31
200607-1076-002 Approved without change	Reinstatement with change of a previously approved collection	2006-07-11
200302-1076-001 Approved without change	Extension without change of a currently approved collection	2003-02-11
199909-1076-002 Approved without change	Extension without change of a currently approved collection	1999-09-30
199606-1076-002 Approved without change	Reinstatement with change of a previously approved collection	1996-06-03
199102-1076-002 Approved without change	Reinstatement with change of a previously approved collection	1991-02-28
198806-1076-001 Approved without change	Reinstatement with change of a previously approved collection	1988-06-30
198506-1076-001 Approved without change	Reinstatement with change of a previously approved collection	1985-06-13
198201-1076-006 Approved without change	New collection (Request for a new OMB Control Number)	1982-01-06