Information Collection

FCC Forms 479, 486 and 500

IC 31206 under ICR 201005-3060-012 · OMB 3060-0853.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0853 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 479 FCC Forms 479, 486 and 500	Form
0853_FCCForm 479 Inst_020807.pdf	Instruction
0853_FCCForm 486 Inst_020807.pdf	Instruction
0853_Form500Inst_to OMB_040507.pdf	Instruction
0853_FCC479Inst_060910.pdf	Instruction
0853_FCC486Inst_060910.pdf	Instruction
0853_FCC500Inst_060910.pdf	Instruction
FCC Form 479 Certification by Administrative Authority to Billed Enti 0853_FCC Form 479_020807.pdf	Form
FCC Form 486 Schools and Libraries Universal Service Receipt of Servi 0853_FCCForm 486_020807.pdf	Form
FCC Form 500 Universal Service for Schools and Libraries, Adjustment 0853_Form500_to OMB_040507.pdf	Form
FCC Form 479 Certification by Administrative Authority to Billed Enti 0853_FCC479_060910.pdf	Form
FCC Form 486 Receipt of Service Confirmaiton Form 0853_FCC486_060910.pdf	Form
FCC Form 500 Admustment to Funding Commitment and Modification to Rec 0853_FCC500_060910.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

FCC Forms 479, 486 and 500

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 54.520

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	FCC Form 479	Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act	0853_FCC Form 479_020807.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			0853_FCCForm 479 Inst_020807.pdf	Yes	No	Fillable Printable
Form	FCC Form 486	Schools and Libraries Universal Service Receipt of Service Confirmation Form	0853_FCCForm 486_020807.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			0853_FCCForm 486 Inst_020807.pdf	Yes	No	Fillable Printable
Instruction			0853_Form500Inst_to OMB_040507.pdf	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 500	Universal Service for Schools and Libraries, Adjustment to Funding Commitment and Modification to Receipt of Service Confirmation Form	0853_Form500_to OMB_040507.pdf	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 479	Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act	0853_FCC479_060910.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			0853_FCC479Inst_060910.pdf	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 486	Receipt of Service Confirmaiton Form	0853_FCC486_060910.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			0853_FCC486Inst_060910.pdf	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 500	Admustment to Funding Commitment and Modification to Receipt of Service Confirmation Form	0853_FCC500_060910.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			0853_FCC500Inst_060910.pdf	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 45,300

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: 65 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	45,300	300	45,000
Annual IC Time Burden (Hours)	63,720	1,220	62,500
Annual IC Cost Burden (Dollars)	0	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.