FCC Form 499-A, Telecommunications Reporting Worksheets

Telecommunications Reporting Worksheets and Related Collections

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0855 can be found here:

Documents and Forms

Document Name Document Type
Form FCC Form 499-A (20 FCC Form 499-A, Telecommunications Reporting Worksheets Form
0855_FCC499-A_Instructions_clean_022709.doc Instruction
FCC Form 499-A (20 Telecommunications Reporting Worksheets 0855_FCC499A_022709.pdf Form

Information Collection (IC) Details

IC Title:	FCC Form 499-A, Telecommunications Reporting Worksheets	Agency IC Tracking Number:	WCB

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 47 CFR 1.47 47 CFR 54.706 47 CFR 54.709 47 CFR 54.711

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 499-A (2009)	Telecommunications Reporting Worksheets	0855_FCC499A_022709.pdf		Yes	Yes	Fillable Fileable Signable
Instruction			0855_FCC499-A_Instructions_clean_022709.doc		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: 5,625	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: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	36,068	36,068
Annual IC Time Burden (Hours)	273,129	273,129
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.