Universal Service- Schools and Libraries Universal Service Program Reimbursement Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0856 can be found here:

Documents and Forms

Document Name Document Type
0856_FCC472inst_030907.pdf Instruction
0856_FCC473Inst_030907.pdf Instruction
0856_FCC474inst_030907.pdf Instruction
FCC Form 472 Billed Entity Applicant Reimbursement Form 0856_FCC472_030907.pdf Form
FCC Form 473 Service Provider Annual Certification Form 0856_FCC473_030907.pdf Form
FCC Form 474 Service Provider Invoice Form 0856_FCC474_030907.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Universal Service- Schools and Libraries Universal Service Program Reimbursement Forms	Agency IC Tracking Number:	Wireline Competition Bureau

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.520 47 CFR 54.504 47 CFR 54.508 47 CFR 54.516

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			0856_FCC472inst_030907.pdf	Yes	No	Fillable Printable
Form	FCC Form 472	Billed Entity Applicant Reimbursement Form	0856_FCC472_030907.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			0856_FCC473Inst_030907.pdf	Yes	No	Fillable Printable
Form	FCC Form 473	Service Provider Annual Certification Form	0856_FCC473_030907.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			0856_FCC474inst_030907.pdf	Yes	No	Fillable Printable
Form	FCC Form 474	Service Provider Invoice Form	0856_FCC474_030907.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 21,200	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: 35 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	91,000	51,700	39,300
Annual IC Time Burden (Hours)	133,650	74,700	58,950
Annual IC Cost Burden (Dollars)	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.