Form FCC Form 655 FCC Form 655 Hearing Aid Compatibility Status Report

Approved by OMB

OMB Control Number

3060-0999

Hearing Aid Compatibility—Application Workflow

• This document is a visual representation of the application steps that a Service Provider or Device Manufacturer follows when submitting a HAC report.

• This document does not include the login process to License Manager or steps to begin/continue a HAC report. These screens are only those questions found on FCC Form 655.

• The application steps which a Service Provider or Device Manufacturer follow are the same, although the screen display may vary depending on the company type. In cases where the screen display is different, both screens are provided and clearly labeled.

• Application Workflow Steps and Screen Outline:

  • Company Information

    • Company Information (Service Provider)

    • Company Information (Device Manufacturer)

  • Handset Model Information

    • Handset Model Information 1 (Service Provider)

    • Handset Model Information 1 (Device Manufacturer)

    • Handset Model Information 2 (Service Provider)

    • Handset Model Information 2 (Device Manufacturer)

    • Report Summary

  • Consumer Outreach Information

    • Consumer Outreach—Product Labeling

    • Consumer Outreach (Service Provider)

    • Consumer Outreach (Device Manufacturer)

  • Certification Page

  • Confirmation Page

FCC Form 655

December 2012

Company Information (Service Provider)

Company Information (Device Manufacturer)

Handset Model Information 1 (Service Provider)

Handset Model Information 1 (Device Manufacturer)

Handset Model Information 2 (Service Provider)

Handset Model Information 2 (Device Manufacturer)

Report Summary (Service Provider and Device Manufacturer)

Consumer Outreach—Product Labeling (Service Provider and Device Manufacturer)

Consumer Outreach (Service Provider)

Consumer Outreach (Device Manufacturer)

Certification Page (Service Provider and Device Manufacturer)

Confirmation Page (Service Provider and Device Manufacturer)

PAPERWORK REDUCTION ACT STATEMENT

We have estimated that your response to this collection of information will take an average of 13.04 hours. Our estimate includes the time to read the instructions, look through existing records, gather and maintain required data, and actually complete and review the form or response. If you have any comments on this estimate, or on how we can improve the collection and reduce the burden it causes you, please write the Federal Communications Commission, Office of Managing Director, AMD‑PERM, Washington, DC 20554, Paperwork Reduction Act Project (3060‑0999). We will also accept your PRA comments via the Internet if you send an e-mail to [email protected].

Please DO NOT SEND COMPLETED FORMS TO THIS ADDRESS. You are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid OMB control number and/or we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060‑0999.

THIS NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW 104-13, OCTOBER 1, 1995, 44 U.S.C. SECTION 3507.

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