Information Collection

Lessee submits request for lease modification

IC 232460 under ICR 202203-1076-001 · OMB 1076-0180.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0180 can be found here:

Documents and Forms

Document Name Document Type
Lessee submits request for lease modification Form
Lease Modification Form Lease_Modification_Form.rtf www.bia.gov/policy-forms/online-forms/paperwork-reduction-act Form
Lease Modification Form Lease_Modification_Form.rtf www.bia.gov/policy-forms/online-forms/paperwork-reduction-act Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Lessee submits request for lease modification	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 226.7

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Lease Modification Form	Lease_Modification_Form.rtf	https://www.bia.gov/policy-forms/online-forms/paperwork-reduction-act	Yes	Yes	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

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.