Information Collection

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

IC 188198 under ICR 201202-3060-017 · OMB 3060-0855.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0855 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 499-Q FCC Forms 499-A and 499-Q, Telecommunications Reporting Worksheets	Form
0855_FCCForm 499-A_Instructions_022912.doc	Instruction
0855_FCCForm 499-Q_Instructions_022912.doc	Instruction
FCC Form 499-Q Telecommunications Reporting Worksheet FCC Form 499-Q (OMB Approved Version).pdf forms.universalservice.org	Form
FCC Form 499-A 2012 Telecommunications Reporting Worksheet 0855_FCCForm499-A_022912.doc	Form

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: Modified

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
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
Instruction			0855_FCCForm 499-A_Instructions_022912.doc		Yes	Yes	Fillable Fileable Signable
Form	FCC Form 499-A	2012 Telecommunications Reporting Worksheet	0855_FCCForm499-A_022912.doc		Yes	Yes	Fillable Fileable Signable
Instruction			0855_FCCForm 499-Q_Instructions_022912.doc		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 %

table that charts list of burden
	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

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.