FCC Form 499-A, and FCC Form 499-Q, 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⚠️ Notice: This information collection may be referencing outdated material.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
0855_FCCForm499-A_Instructions_Revised 2010_021810.doc forms.universalservice.org Instruction
0855_FCCForm499-Q_Instructions_ Revised 2010_021810.doc forms.universalservice.org Instruction
FCC Form 499-A Telecommunications Reporting Worksheet 0855_FCCForm499A_Revised2010_021810.pdf forms.universalservice.org Form
FCC Form 499-Q Telecommunications Reporting Worksheet 0855_FCC 499Q_Revised2010_021810.pdf forms.universalservice.org Form

Information Collection (IC) Details

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

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

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

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			0855_FCCForm499-A_Instructions_Revised 2010_021810.doc	http://forms.universalservice.org	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 499-A	Telecommunications Reporting Worksheet	0855_FCCForm499A_Revised2010_021810.pdf	http://forms.universalservice.org	Yes	Yes	Fillable Fileable Signable
Instruction			0855_FCCForm499-Q_Instructions_ Revised 2010_021810.doc	http://forms.universalservice.org	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 499-Q	Telecommunications Reporting Worksheet	0855_FCC 499Q_Revised2010_021810.pdf	http://forms.universalservice.org	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: 5,800	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	44,574	8,506	36,068
Annual IC Time Burden (Hours)	281,710	8,581	273,129
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.