Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 474 Service Provider Invoice Form	Form	Modified	Available
Form FCC Form 473 Service Provider Annual Certification Form	Form	Modified	Available
Form FCC Form 472 Billed Entity Applicant Reimbursement Form	Form	Modified	Available
0856_ss_042710.doc	Supporting Statement A	Uploaded 2010-04-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
31231	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	Form	Modified	Service Provider Invoice Form
31231	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	Form	Modified	Service Provider Annual Certification Form
31231	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	Form	Modified	Billed Entity Applicant Reimbursement Form
31231	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	Instruction	Modified
191854	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms		New

ICR Details

OMB Control No: 3060-0856	ICR Reference No: 201001-3060-011
Status: Historical Active	Previous ICR Reference No: 200702-3060-014
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/04/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/27/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2013	36 Months From Approved	06/30/2010
Responses	97,100	0	91,000
Time Burden (Hours)	143,150	0	133,650
Cost Burden (Dollars)	0	0	0

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Abstract: The Telecommunications Act of 1996 contemplates that discounts on eligible services shall be provided to schools and libraries, and that service providers shall seek reimbursement to the amount of the discounts. FCC Forms 473 and 474 facilitate the reimbursement process. FCC Form 472 allows providers to confirm that they are actually providing the discounted services to eligible entities.

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Authorizing Statute(s): US Code: 47 USC 254 Name of Law: Communications Act of 1934
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 6394	02/09/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 20994	04/22/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	FCC Form 472, FCC Form 473, FCC Form 474	Billed Entity Applicant Reimbursement Form ,   Service Provider Annual Certification Form ,   Service Provider Invoice Form
Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	97,100	91,000	0	0	6,100	0
Annual Time Burden (Hours)	143,150	133,650	0	0	9,500	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Commission is reporting an increase in the total annual burden which is due to a 6,100 increase in the number of responses. Therefore, the Commission is reporting a 9,500 hour increase in the total annual burden hours. The adjustment in burden is due to updated information based on actual participation in the E-rate program.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/27/2010

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