Application for Converter Box Coupons for Consumers using Post Office Boxes for Mail Receipt

Application for Digital-to-Analog Converter Box Coupons for Consumers Using Post Office Boxes for Mail Receipt

Documents and Forms

Document Name Document Type
Application for Converter Box Coupons for Consumers using Post Office Boxes for Mail Receipt Form and Instruction
Application for Converter Box Coupons for Consumers usin 0660[2].Draft PO Box Coupon Application..doc Form and Instruction

Information Collection (IC) Details

IC Title:	Application for Converter Box Coupons for Consumers using Post Office Boxes for Mail Receipt	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Application for Converter Box Coupons for Consumers using P.O. Boxes	0660[2].Draft PO Box Coupon Application..doc		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 340,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	340,000	340,000
Annual IC Time Burden (Hours)	113,333	113,333
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.