View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 3060-1258	ICR Reference No: 202405-3060-009
Status: Historical Active	Previous ICR Reference No: 202107-3060-005
Agency/Subagency: FCC	Agency Tracking No: OWD
Title: Alternative Dispute Resolution Form Requests, FCC Form 5628
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Delegated
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/18/2024
	Date Received in OIRA: 06/18/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2027	36 Months From Approved	07/31/2024
Responses	3	0	7
Time Burden (Hours)	13	0	25
Cost Burden (Dollars)	3,750	0	10,000

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	3	7	-4
Annual Time Burden (Hours)	13	25	-12
Annual Cost Burden (Dollars)	3,750	10,000	-6,250

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Commission is reporting adjustments to this information collection. The total number of respondents decreased by -4, the total annual responses decreased by -4, the total annual burden hours decreased by -12 hours and the total annual costs decreased by -$6,250. These calculations are based on the most currently available data to the Commission. No program changes are being reported to this collection.

Annual Cost to Federal Government: $13,990

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: Jedidiah Gibson 202 418-1080 jedidiah.gibson@fcc.gov

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