Information Collection

Universal Service - Rural Health Care Program

IC 31049 under ICR 201002-3060-017 · OMB 3060-0804.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0804 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 465 Universal Service - Rural Health Care Program	Form and Instruction
FCC Form 465 Universal Service - Rural Health Care Program - For seek 0804_FCCForm465_FY2010_022510.pdf	Form and Instruction
FCC Form 466 Universal Service - Rural Health Care Program - Form for 0804_FCCForm466_FY2010_022510.pdf	Form and Instruction
FCC Form 466-A Universal Service - Rural Health Care Program - Form for 0804_FCCForm466-A_FY2010_022510.pdf	Form and Instruction
FCC Form 467 Universal Service - Rural Health Care Program - Form for 0804_FCCForm467_FY2010_022510.pdf	Form and Instruction

IC Title:

Universal Service - Rural Health Care Program

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 54.601-54.625

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FCC Form 465	Universal Service - Rural Health Care Program - For seeking bids	0804_FCCForm465_FY2010_022510.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 466	Universal Service - Rural Health Care Program - Form for funding request and certification	0804_FCCForm466_FY2010_022510.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 466-A	Universal Service - Rural Health Care Program - Form for selection of service provider	0804_FCCForm466-A_FY2010_022510.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 467	Universal Service - Rural Health Care Program - Form for notification of service initiation	0804_FCCForm467_FY2010_022510.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: 6,494

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	59,464	59,464
Annual IC Time Burden (Hours)	67,468	67,468
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.