Consumer Complaint Form

ICR 200105-3060-002

OMB: 3060-0874

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
31261 Migrated
ICR Details
3060-0874 200105-3060-002
Historical Active 199909-3060-023
FCC
Consumer Complaint Form
Revision of a currently approved collection   No
Emergency 05/18/2001
Approved without change 05/24/2001
Retrieve Notice of Action (NOA) 05/16/2001
  Inventory as of this Action Requested Previously Approved
11/30/2001 11/30/2001 11/30/2002
58,772 0 80,000
29,386 0 40,000
0 0 0

FCC Form 475 allows the Commission to collect detailed data from consumers on the practices of common carriers. The information contained in the collections will allow consumers to provide the Commission with the relevant information required and help consumers to develop a concise statement outlining the issue in dispute. The information will then be used to assist in the resolution of informal comoplaints and to collect data required to assess the practices of common carriers. FCC Form 475 has been revised to consolidate and streamline information requirements. FCC Form 476 is being eliminated.

None
None


No

1
IC Title Form No. Form Name
Consumer Complaint Form FCC-475

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 58,772 80,000 0 -21,228 0 0
Annual Time Burden (Hours) 29,386 40,000 0 -10,614 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/16/2001


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