Information Collection

FCC Form 499-A, Telecommunications Reporting Worksheets

IC 188198 under ICR 200902-3060-030 · OMB 3060-0855.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.