10-404 Backcountry/Wilderness Use Permit Application (Individuals)

Backcountry/Wilderness Use Permit (36 CFR 1.5, 1.6, and 2.10)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0022 can be found here:

Documents and Forms

Document Name Document Type
Form 10-404 10-404 Backcountry/Wilderness Use Permit Application (Individuals) Form and Instruction
10-404 Backcountry/Wilderness Use Permit Application 10-404 Backcountry-Wilderness Use Permit Application 04062017.docx Form and Instruction

Information Collection (IC) Details

IC Title:	10-404 Backcountry/Wilderness Use Permit Application (Individuals)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 1.5, 1.6, and 2.10

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10-404	Backcountry/Wilderness Use Permit Application	10-404 Backcountry-Wilderness Use Permit Application 04062017.docx		No		Paper Only

Line of Business: Natural Resources

Subfunction: Recreational Resource Management and Tourism

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 172,928	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	172,928	-112,072	285,000
Annual IC Time Burden (Hours)	23,057	-693	23,750
Annual IC Cost Burden (Dollars)	0	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.