Information Collection

Universal Service- Schools and Libraries Universal Service Program Reimbursement Forms

IC 31231 under ICR 200702-3060-014 · OMB 3060-0856.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.