Information Collection

Application - Special Purpose - Miscellaneous (Form 3-200-10f) - Individuals

IC 180863 under ICR 201806-1018-006 · OMB 1018-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1018-0022 can be found here:

Documents and Forms

Document Name Document Type
Form 3-200-10f Application - Special Purpose - Miscellaneous (Form 3-200-10f) - Individuals Form and Instruction
3-200-10f Special Purpose - Miscellaneous Permit Application Form 3-200-10f Application - Special Purpose - Miscellaneous Rev 02-2018.pdf www.fws.gov/forms Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application - Special Purpose - Miscellaneous (Form 3-200-10f) - Individuals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 50 CFR 21

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3-200-10f	Special Purpose - Miscellaneous Permit Application Form	3-200-10f Application - Special Purpose - Miscellaneous Rev 02-2018.pdf	http://www.fws.gov/forms	Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title: Permits System - Interior, FWS-21	FR Citation: 68 FR 52610

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	2,500	2,500

Documents for IC

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.