250.192(b) - Initial Damage Report

30 CFR 250, Subpart A, General

Documents and Forms

Document Name Document Type
Form Form BSEE-0143 250.192(b) - Initial Damage Report Form
PAPERWORK REDUCTION ACT STATEMENT for eWell.docx ewell.bsee.gov/ewell/ Other-PRA Statement for eWell
PAPERWORK REDUCTION ACT STATEMENT for eWell.docx ewell.bsee.gov/ewell/ Other-PRA Statement for eWell
Form BSEE-0143 FACILITY/EQUIPMENT DAMAGE REPORT Form 0143 exp 2024.docx www.bsee.gov/about-bsee/doing-business-with-bsee Form
Form BSEE-0143 FACILITY/EQUIPMENT DAMAGE REPORT Form 0143 exp 2024.docx www.bsee.gov/about-bsee/doing-business-with-bsee Form

Information Collection (IC) Details

IC Title:	250.192(b) - Initial Damage Report	Agency IC Tracking Number:	1014-0022 '23

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 250.192(b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form BSEE-0143	FACILITY/EQUIPMENT DAMAGE REPORT	Form 0143 exp 2024.docx	https://www.bsee.gov/about-bsee/doing-business-with-bsee	Yes	Yes	Fillable Fileable
Other-PRA Statement for eWell			PAPERWORK REDUCTION ACT STATEMENT for eWell.docx	https://ewell.bsee.gov/ewell/	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4	Number of Respondents for Small Entity: 3

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

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Previously Approved
Annual Number of Responses for this IC	4	4
Annual IC Time Burden (Hours)	12	12
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.