Information Collection

FCC Form 497

IC 31116 under ICR 201106-3060-017 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form FCC 497 FCC Form 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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FCC Form 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:

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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	16,800	16,800
Annual IC Time Burden (Hours)	25,200	25,200
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.