Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0856 can be found here:

Documents and Forms

Document Name Document Type
Form FCC Form 472 Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms Form
0856_FCCForm472Instructions_052913.docx Instruction
0856_FCCForm473Instructions_052913.docx Instruction
0856_FCCForm474Instructions_052913.docx Instruction
FCC Form 472 Billed Entitiy Applicant Reimbursement Form 0856_FCCForm472_052913.docx www.usac.org/sl/tools/forms/default.aspx Form
FCC Form 473 Universal Service for Schools and Libraries - Service Pr 0856_FCCForm473_052913.docx www.usac.org/sl/tools/forms/default.aspx Form
FCC Form 474 Schools and Libraries Universal Service - Service Provid 0856_FCCForm474_052913.docx www.usac.org/sl/tools/forms/default.aspx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	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 54.504 47 CFR 54.508 47 CFR 54.516 47 CFR 54.520

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 472	Billed Entitiy Applicant Reimbursement Form	0856_FCCForm472_052913.docx	http://www.usac.org/sl/tools/forms/default.aspx	Yes	Yes	Fillable Fileable Signable
Instruction			0856_FCCForm472Instructions_052913.docx		Yes	Yes	Fillable Fileable Signable
Form	FCC Form 473	Universal Service for Schools and Libraries - Service Provider Annual Certification Form	0856_FCCForm473_052913.docx	http://www.usac.org/sl/tools/forms/default.aspx	Yes	Yes	Fillable Fileable Signable
Instruction			0856_FCCForm473Instructions_052913.docx		Yes	Yes	Fillable Fileable Signable
Form	FCC Form 474	Schools and Libraries Universal Service - Service Provider Invoice	0856_FCCForm474_052913.docx	http://www.usac.org/sl/tools/forms/default.aspx	Yes	Yes	Fillable Fileable Signable
Instruction			0856_FCCForm474Instructions_052913.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,963	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	79,083	30,533	48,550
Annual IC Time Burden (Hours)	79,083	7,508	71,575
Annual IC Cost Burden (Dollars)	0	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.