DTV converter box data collection

Application for the Digital-to-Analog Converter Box Coupon

Documents and Forms

Document Name Document Type
Form DTV-1 DTV converter box data collection Form and Instruction
DTV-1 Digital-to-Analog Television Converter Box Coupon Progra Coupon App Pckg 10-30.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	DTV converter box data collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 301

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DTV-1	Digital-to-Analog Television Converter Box Coupon Program Application	Coupon App Pckg 10-30.pdf	TBD	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 110,000,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	110,000,000	110,000,000
Annual IC Time Burden (Hours)	27,500,000	27,500,000
Annual IC Cost Burden (Dollars)	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.