Information Collection

Fcc 497

IC 31116 under ICR 201011-3060-003 · OMB 3060-0819.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0819 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC 497 FCC 497	Form and Instruction
FCC 497 Lifeline and Link Up Worksheet (and Instructions) 0819_FCC Form 497 and Instructions_062708 final.xls www.universalservice.org/li/telecom/step06/form497.aspx	Form and Instruction

IC Title:

FCC 497

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 54.400 - 54.417

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FCC 497	Lifeline and Link Up Worksheet (and Instructions)	0819_FCC Form 497 and Instructions_062708 final.xls	http://www.universalservice.org/li/telecom/step06/form497.aspx	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,400

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 10 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	16,800	-10,200	27,000
Annual IC Time Burden (Hours)	25,200	-16,200	41,400
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.