Universal Service - Rural Health Care Program

Universal Service - Rural Health Care Program

OMB: 3060-0804

IC ID: 199666

Information Collection (IC) Details

View Information Collection (IC)

Universal Service - Rural Health Care Program WCB
 
No Modified
 
Required to Obtain or Retain Benefits
 
47 CFR 54.600 - 54.680

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Template 0804_Attachment 9 - Certification of Program Participant Template_062813.doc Yes Yes Fillable Fileable Signable
Other-Template 0804_Attachment 10 - Vendor Certification Template_062813.doc Yes Yes Fillable Fileable Signable
Form FCC Form 460 Eligibility and Registration Form 0804_Attachment 11_FCC Form 460_062813.pdf Yes Yes Fillable Fileable Signable
Instruction 0804_Attachment 12_FCC Form 460 Instructions_062813.docx Yes Yes Fillable Fileable Signable
Form FCC Form 461 Healthcare Connect Fund Request for Services Form 0804_Attachment 13_FCC Form 461_062813.pdf Yes Yes Fillable Fileable Signable
Instruction 0804_Attachment 14_FCC Form 461 Instructions_062813.docx Yes Yes Fillable Fileable Signable
Instruction 0804_Attachment 15_FCC Form 462 Instructions_062813.docx Yes Yes Fillable Fileable Signable
Form FCC Form 462 Healthcare Conect Fund Funding Request Form 0804_Attachment 16_FCC Form 462 with NCW_062813.pdf Yes Yes Fillable Fileable Signable

Health Health Care Services

 

3,667 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   98 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 18,015 0 0 0 0 18,015
Annual IC Time Burden (Hours) 21,847 0 0 0 0 21,847
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

© 2024 OMB.report | Privacy Policy