FCC Forms 499-A and 499-Q, Telecommunications Reporting Worksheets

Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q

⚠️ Notice: This information collection may be referencing outdated material.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
2011 Instruct - Changes (10-11-11)(REDLINE)(Form 499-A).doc forms.universalservice.org Instruction
2012 Instruct - Changes (10-11-11)(REDLINE)(Form 499-A).doc forms.universalservice.org Instruction
FCC Form 499-Q Instructions (OMB Approved Version).doc forms.universalservice.org Instruction
FCC Form 499-Q Telecommunications Reporting Worksheet FCC Form 499-Q (OMB Approved Version).pdf forms.universalservice.org Form
FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2010 R FCC Form 499-A 2011.pdf http:/forms.universalservice.org Form
FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2011 R FCC Form 499-A 2012.pdf http:/forms.universalservice.org Form

Information Collection (IC) Details

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

Is this a Common Form? No		IC Status: Unchanged

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			2012 Instruct - Changes (10-11-11)(REDLINE)(Form 499-A).doc	http://forms.universalservice.org	Yes	Yes	Fillable Fileable Signable
Instruction			FCC Form 499-Q Instructions (OMB Approved Version).doc	http://forms.universalservice.org	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 499-Q	Telecommunications Reporting Worksheet	FCC Form 499-Q (OMB Approved Version).pdf	http://forms.universalservice.org	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 499-A	Telecommunications Reporting Worksheet (Reporting 2010 Revenues)	FCC Form 499-A 2011.pdf	http:/forms.universalservice.org	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 499-A	Telecommunications Reporting Worksheet (Reporting 2011 Revenues)	FCC Form 499-A 2012.pdf	http:/forms.universalservice.org	Yes	Yes	Fillable Fileable Signable
Instruction			2011 Instruct - Changes (10-11-11)(REDLINE)(Form 499-A).doc	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: 8,183	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Previously Approved
Annual Number of Responses for this IC	46,957	46,957
Annual IC Time Burden (Hours)	313,881	313,881
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.