Connect America Challenge Process and Certifications (State, local or tribal Government)

Connect America Challenge Process and Certifications, FCC Form 505

Documents and Forms

Document Name Document Type
1188 Instructions FCC Form 505_092513.doc Instruction
FCC 505 Connect America Phase II Challenge Process Form 505 1188 FCC Form 505_092513.xls Form

Information Collection (IC) Details

IC Title:	Connect America Challenge Process and Certifications (State, local or tribal Government)	Agency IC Tracking Number:	WCB

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.312 47 CFR 54.313

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			1188 Instructions FCC Form 505_092513.doc		Yes	Yes	Fillable Fileable
Form	FCC 505	Connect America Phase II Challenge Process Form 505	1188 FCC Form 505_092513.xls		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Previously Approved
Annual Number of Responses for this IC	9	9
Annual IC Time Burden (Hours)	90	90
Annual IC Cost Burden (Dollars)	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.