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OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT

Forms Library

Forms, Applications, & Instructions

This site provides the most current official version of forms, applications, and instructions. We are linking you directly to the websites of the originators of the forms. This site links to the following form libraries: Department of the Interior, Office of Personnel Management, General Services Administration, and other forms.

Originating
Agency

File Type

Expiration
Date

Description

(OSM) - Office of Surface Mining Forms Library

OSM-1

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11/2011

Coal Reclamation Fee Report

OSM-1
Amended

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11/2011

Amended, Coal Reclamation Fee Report 

OSM-1

Online


Coal Reclamation Fee Report File

OSM-1
Instructions

pdf icon (39 KB)

11/30/11

Instructions for OSM-1, Coal Reclamation Fee Report 

OSM-23

pdf icon (26 KB)

09/30/11

State Employee Statement of Employment and Financial Interest

OSM-23

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09/30/11

State Employee Statement of Employment and Financial Interest

Guidelines for State and Ethics Program

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Guidelines for Completing Form OSM-23


OSM-74


word icon (127 KB)



12/31/11

Application for Blaster Certification in Federal Program States and on Indian Lands

Use to request a blaster certification in Federal Program States and on Indian Lands

OMB 1029-0061

pdf icon (43 KB)

08/31/09

Small Operator Assistance Application

OMB 1029-0119

pdf icon (13 KB)

01/31/10

Abandoned Mine Land Contractor

OMB 1029-0119

Instructions

pdf icon (39 KB)

01/31/10

Instructions for Abandoned Mine Land Contractor

Bond Forms

General Purpose Rider for Surety Bond

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01/31/09


 

Assignment of Certificate of Deposit for Collateral Bond (Corporation)

 

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01/31/09



Assignment of Certificate of Deposit for Collateral Bond (Partnership)

 

 

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01/31/09


 

Assignment of Certificate of Deposit for Collateral Bond (Sole Proprietorship)

 

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01/31/09


Escrow Agreement

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01/31/09



Amendment to Collateral Bond and Indemnity Agreement (Corporation)

 

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01/31/09


Amendment to Collateral Bond and Indemnity Agreement (Partnership)

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01/31/09


Amendment to Collateral Bond and Indemnity Agreement (Sole Proprietorships)

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01/31/09


Directives Templates

OPM-1 Format Template

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Use this sample template to create a Directive

Comment Template

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Use this sample comment form when preparing a Directive

Change Notice

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Use this sample change notice form when making changes to an existing Directive

Rescission Change Notice

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Use this sample rescission change notice template to rescend a Directive

Freedom of Information Act (FOIA) Form

Freedom of Information Act (FOIA) Request Form

pdf icon (29 KB)


Freedom of Information Act Form

Safety Form

Safety Orientation Checklist

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Checklist for: Administrative Officers, Collateral Duty Safety Officers and Personnel

Technology Transfer Forms

Technical Assistance Evaluation

pdf icon (824 KB)

03/31/11

Your response to this survey will assist us in evaluating and improving our performance on the technical assistance provided for a project or activity (electronic version)

Meeting/Forum Evaluation

pdf icon (637 KB)

03/31/11

Your response to this survey will assist us in evaluating and improving the OSM meeting/forum in which you participated (electronic version)

Meeting/Forum Evaluation

pdf icon (636 KB)

03/31/11

Your response to this survey will assist us in evaluating and improving the OSM meeting/forum in which you participated (paper version)

(DI) - Department of the Interior Forms

(OPM) - Office of Personnel Management Forms

(GS) - General Services Administration Forms