Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0856 can be found here:

Documents and Forms

Document Name Document Type
0856_FCC472inst_030907.pdf Instruction
0856_FCC473Inst_030907.pdf Instruction
0856_FCC474inst_030907.pdf Instruction
FCC Form 472 Billed Entity Applicant Reimbursement Form 0856_FCC472_030907.pdf Form
FCC Form 473 Service Provider Annual Certification Form 0856_FCC473_030907.pdf Form
FCC Form 474 Service Provider Invoice Form 0856_FCC474_030907.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	Agency IC Tracking Number:	WCB

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.504 47 CFR 54.508 47 CFR 54.516 47 CFR 54.520

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			0856_FCC473Inst_030907.pdf	Yes	No	Fillable Printable
Instruction			0856_FCC472inst_030907.pdf	Yes	No	Fillable Printable
Form	FCC Form 472	Billed Entity Applicant Reimbursement Form	0856_FCC472_030907.pdf	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 473	Service Provider Annual Certification Form	0856_FCC473_030907.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			0856_FCC474inst_030907.pdf	Yes	No	Fillable Printable
Form	FCC Form 474	Service Provider Invoice Form	0856_FCC474_030907.pdf	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: 11,100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 72 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	48,550	-42,450	91,000
Annual IC Time Burden (Hours)	71,575	-62,075	133,650
Annual IC Cost Burden (Dollars)	0	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.