REV101167

• Permit No: C1980007
• IBM Index Class Name: Revision
• Doc Date: 12/6/2004
• Doc Name: Copy of Federal Coal Lease ‎(COC67011)‎
• From: BLM
• To: DMG
• Type & Sequence: PR11
• Media Type: D
• Archive: No

Sec. 15. SPECIAL STIPULATIONS (Contd.) -
NOTICE
The Privacy Act and the regulation at 43 CFR 2.48(d) provide that you be famished with the following information in connection with the
information required by this lease.
AUTHORITY: 30 U.S.C. 181 et seq., 30 U.S.C. 351-359
PRINCIPAL PURPOSE: The information required by this ]ease is used to allow the BLM to gather data relevant to the extent and quality
of public coal resources and [o manage the leasing and development of coal in the public interest.
ROUTINE USES: (1) Report the amount of coal leased, entities to whom leased, and, in aggregate, production from leases for revenue
and other purposes. (2) Subject to restrictions and condiuoas stated in the lease, authorize the site-specific extraction of public coal
resources.
EFFECT OF NOT PROVIDING INFORMATION: Report and disclosure of the information is mandatory for all lessees.
The Paperwork Reduction Act of 1980 (44 U.S.C. 3501, et seq.) requires us to inform you that:
This information is being collected to authorize and evaluate proposed aad ongoing mining operations on federal coal leases and to
compute revenues owed to lessor.
Response to this request is mandatory for the types of activities specified in 43 CFR Group 3400.
BURDEN HOURS STATEMENT
Public reporting burden for this form is estimated to range from 25 minutes for reviewing the instmctions and completing and signing the
lease form to 500 burden hours for complying with the information requirements connected with resource recovery and exploration plans
and mining plans. Direct comments regarding the burden estimate or any other aspeM of this form to: U.S. Department of the Interior,
Bureau of Land Management, (Alternate) Bureau Cleazance Officer, ]849 C St., N.W., Washington, D.C. 20240, and [he Office of
Management and Budge[, Paperwork Reduction Project (1004-0073), Washington, D.C. 20503
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Title 18 U.S.C. Section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency of the United States any
false, fictitAous or fraudulent statements or representations as to any matter within its jurisdiction.
This form does not constitute an information collection as defined by 44 U.S.C. 3502 and therefore does not require OMB approval.
rt U.S. GOVERNMENT PRINTING OFFICE: 1995-674-T32