Universal Service - Rural Health Care Program

Universal Service - Rural Health Care Program

OMB: 3060-0804

IC ID: 207576

Information Collection (IC) Details

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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
Form FCC Form 463 Healthcare Connect Fund Invoice and Request for Disbursement Form 0804_Attachment 17_FCC Form 463_062813.pdf Yes Yes Fillable Fileable Signable
Instruction 0804_Attachment 18_FCC Form 463 Instructions_062813.docx Yes Yes Fillable Fileable Signable
Form FCC Form 465 Description of Services Requested & Certification Form 0804_Attachment 19_ FCC Form 465_062813.pdf Yes Yes Fillable Fileable Signable
Instruction 0804_Attachment 20_FCC Form 465 Instructions_06281`3.pdf Yes Yes Fillable Fileable Signable
Form FCC Form 466 Funding Request and Certification Form 0804_Attachment 21_FCC Form 466_062813.pdf Yes Yes Fillable Fileable Signable
Instruction 0804_Attachment 22_FCC Form 466 Instructions_062813.pdf Yes Yes Fillable Fileable Signable
Form FCC Form 466-A Internet Service Funding Request and Certification Form 0804_Attachment 23_FCC Form 466-A_062813.pdf Yes Yes Fillable Fileable Signable
Instruction 0804_Attachment 24_FCCForm 466-A Instructions_062813.pdf Yes Yes Fillable Fileable Signable
Form FCC Form 467 Connection Certification 0804_Attachment 25_FCC Form 467_062813.pdf Yes Yes Fillable Fileable Signable
Instruction 0804_Attachment 26_FCC Form 467 Instructions_062813.pdf Yes Yes Fillable Fileable Signable

Health Health Care Services

 

3,666 0
   
Federal Government
 
   95 %

  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 18,011 0 0 0 0 18,011
Annual IC Time Burden (Hours) 21,845 0 0 0 0 21,845
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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