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OMB Control No: 1004-0012	ICR Reference No: 202411-1004-002
Status: Received in OIRA	Previous ICR Reference No: 202108-1004-004
Agency/Subagency: DOI/BLM	Agency Tracking No: 2025 Renewal
Title: Application for Land for Recreation or Public Purposes (43 CFR 2740 and 2912)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 12/19/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2025
Responses	23	23
Time Burden (Hours)	920	920
Cost Burden (Dollars)	2,300	2,300

Annual Cost to Federal Government: $43,810

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Darrin King 202-693-4129 King.Darrin@dol.gov