Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act

Compliance with the Children's Internet Protection Act; Receipt of Service Confirmation Form; and Funding Commitment Change Request Form

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
0853_FCCForm 479 Inst_020807.pdf Instruction
0853_FCCForm 486 Inst_020807.pdf Instruction
0853_Form500Inst_to OMB_040507.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

Information Collection (IC) Details

IC Title:	Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act	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:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
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_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

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 45,000	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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	45,000	45,000
Annual IC Time Burden (Hours)	62,500	62,500
Annual IC Cost Burden (Dollars)	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.