Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0855_2014 FCC Form 499-A (clean)_121313.docx	Supplementary Document	Uploaded 2013-12-16	Available
0855_2014 FCC Form 499-A Instructions (clean)_121313.docx	Supplementary Document	Uploaded 2013-12-16	Available
0855_2014 FCC Form 499-Q (clean)_121113.docx	Supplementary Document	Uploaded 2013-12-16	Available
0855_2014 FCC Form 499-Q (clean)_121113.docx	Supplementary Document	Uploaded 2013-12-16	Available
0855 Explanation of Non-Substantive Changes (12 11 13).doc	Supplementary Document	Uploaded 2013-12-16	Available
0855_Non_SubstantiveChangeRequest_090813.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2013-09-10	Available
0855_NonSubstantiveChangeAbstract_090413.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2013-09-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
188198	FCC Forms 499-A and 499-Q, Telecommunications Reporting Worksheets	Instruction	Unchanged

ICR Details

OMB Control No: 3060-0855	ICR Reference No: 201312-3060-006
Status: Historical Inactive	Previous ICR Reference No: 201309-3060-001
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 01/02/2014
	Date Received in OIRA: 12/31/2013
Terms of Clearance: Will be corrected and resubmitted.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2014	10/31/2014	10/31/2014
Responses	46,957	0	46,957
Time Burden (Hours)	313,881	0	313,881
Cost Burden (Dollars)	0	0	0

---

Abstract: The Federal Communications Commission (Commission) requires telecommunications carriers and other providers of telecommunications to contribute to the Telecommunications Relay Service Fund. Contribution revenue data, as well as other information, are reported by carriers on FCC Forms 499-A (annual) and 499-Q (quarterly). Accompanying these forms are instructions on how to report revenue. On October 7, 2011, the Commission released the Contributions to the TRS Fund Report and Order (Report and Order) FCC 11-150, adopting rules to implement section 715 of the Act. The Report and Order takes the following actions: requires non-interconnected VoIP service providers with interstate end-user revenues that are subject to contribution to the TRS Fund to register with the Commission, designate a District of Columbia agent for service of process, annually file FCC Form 499-A, and contribute to the TRS Fund; extends the 64.9 percent safe harbor provision for calculating interstate end-user revenues to non-interconnected VoIP service providers; maintains interstate end-user revenues as the basis for calculating TRS Fund contributions; requires no contributions to the TRS Fund by non-interconnected VoIP service providers that offer services for free and have zero interstate end-user revenues. On May 23, 2011, the Commission received preapproval for the proposed requirements and changes to FCC Form 499-A from the OMB. The requirements were adopted as proposed with some non-substantial changes to the instructions of Form 499-A. This submission is being made to OMB to receive final OMB approval for the requirements and form changes.

---

Authorizing Statute(s): US Code: 47 USC 155 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 157 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 201 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 151 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 205 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 214 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 225 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 254 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 303(r) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 616 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 620 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(j) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(i) Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3060-AJ63	Final or interim final rulemaking	76 FR 18490	04/04/2011

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 18490	04/04/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 18490	04/04/2011
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
FCC Forms 499-A and 499-Q, Telecommunications Reporting Worksheets	FCC Form 499-A, FCC Form 499-Q	Telecommunications Reporting Worksheet - Quarterly Filing for Universal Service Contributors ,   2013 Telecommunications Reporting Worksheet (Reporting 2012 Revenues)

---

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/31/2013

---