View Information Collection (IC)

View Information Collection (IC)

IC Title:	Business or other for-profit	Agency IC Tracking Number:	WCB

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.1710(a)-(b) 47 CFR 54.1711(a)-(b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 471	Description of Services Requested and Certification ECF	3060-xxxx FCC 21-58 Emergency Connectivity Fund FCC Form 471 (5.12.2021).docx		Yes	Yes	Fillable Fileable Signable
Other-Screenshot - Request for Reimbursement (ECF)			3060-xxxx FCC 21-58 Emergency Connectivity Fund Request for Reimbursement (FCC Forms 472-474) (5.12.2021).docx		Yes	Yes	Fillable Fileable Signable
Other-Screenshot - Post Commitment Change Request (ECF)			3060-xxxx FCC 21-58 Emergency Connectivity Fund Post-Commitment Change Request (5.12.2021).docx		Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	66,050	0	66,050	0	0	0
Annual IC Time Burden (Hours)	157,725	0	157,725	0	0	0
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.