Information Collection

FCC Form 180 (state, local or tribal respondents)

IC 201291 under ICR 201206-3060-006 · OMB 3060-1166.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-1166 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 180 FCC Form 180 (state, local or tribal respondents)	Form and Instruction
FCC Form 180 Application to Participate in an Auction for Mobility Fu 1166_Mobility_Fund_Short_Form180_061512.doc	Form and Instruction

IC Title:

FCC Form 180 (state, local or tribal respondents)

Agency IC Tracking Number:

WTB

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 1.21001 - 1.21004

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 Form 180	Application to Participate in an Auction for Mobility Fund Phase I Support	1166_Mobility_Fund_Short_Form180_061512.doc		Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 125

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	125	125
Annual IC Time Burden (Hours)	187	187
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.