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Placer Mining Claim Patent Applicatoin / 10 or Fewer Claims (43 CFR subpart 3863)

IC 204996 under ICR 202411-1004-001 · OMB 1004-0025.

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IC Title:	Placer Mining Claim Patent Applicatoin / 10 or Fewer Claims (43 CFR subpart 3863)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 43 CFR 3863.1 43 CFR 3860.1 43 CFR 3000.11 43 CFR 3000.12

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

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 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1	0	1
Annual IC Time Burden (Hours)	80	0	80
Annual IC Cost Burden (Dollars)	42,155	285	41,870

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.