View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 1004-0012	ICR Reference No: 202411-1004-002
Status: Active	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
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/30/2025
	Date Received in OIRA: 12/19/2024
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years. OMB reminds the Agency, however, it should consult with up to 9 outside entities at least once every 3 years even if the collection of information has not changed.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2028	36 Months From Approved	12/31/2025
Responses	23	0	23
Time Burden (Hours)	920	0	920
Cost Burden (Dollars)	2,300	0	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

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