View Information Collection (IC)

View Information Collection (IC)

IC Title:	Universal Service - Schools and Libraries Universal Service Program, FCC Form 471, State, Local, or Tribal Governments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.500(a) - (r) 47 CFR 54.501(a) - (c) 47 CFR 54.502(a) - (d) 47 CFR 54.503(a) - (e) 47 CFR 54.504(a) - (f) 47 CFR 54.505(a) - (f) 47 CFR 54.507(b) - (f) 47 CFR 54.509(a) 47 CFR 54.511(a) 47 CFR 54.516 47 CFR 54.519 47 CFR 54.523 47 CFR 54.5

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form 471	Description of Services Requested and Certification - Field Description	3060-0806 FCC Form 471 Revision field descriptions (2015).docx		Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 38,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	38,000	0	0	0	0	38,000
Annual IC Time Burden (Hours)	171,000	0	0	0	0	171,000
Annual IC Cost Burden (Dollars)	0	0	0	0	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.