Lifeline and Link Up Reform and Modernization, Advancing Broadband Availability Through Digital Literacy Training and FCC Forms 481, 497, 550, 555 and 560

Forms and Documents

Document Name	Status
Form FCC Form 481 FCC Form 481, 54.313/54.422 Data Collection Form Form	Unchanged
Form FCC Form 560 FCC Form 560, Low Income Brodband Pilot Program Reporting Form Form and Instruction	Unchanged
Form FCC Form 555 FCC Form 555, Annual Lifeline Eligible Telecommunications Carrier Certification Form Form and Instruction	Unchanged
Form FCC Form 550 FCC Form 550, Low Income Broadband Pilot Program Reimbursement Form Form and Instruction	Unchanged
Form FCC Form 497 FCC Form 497 and instructions - individuals or households Form and Instruction	Unchanged
3060-0819 FCC-Form-555 Non-Substantive Change (4 20 15) Final.doc Justification for No Material/Nonsubstantive Change	2015-04-20
3060-0819 FCC-Form-555-Instructions Non-Substantive Change (4 20 15) Final.doc Justification for No Material/Nonsubstantive Change	2015-04-20
3060-0819 Explanation for FCC Form 555 Non-substantitve Change 4_2015 FINAL.doc Justification for No Material/Nonsubstantive Change	2015-04-20
3060-0819 FCC Form 555 (Clean) October2014.docx Supplementary Document	2014-10-24
3060-0819 FCC Form 555 Instructions (Clean) October2014.docx Supplementary Document	2014-10-24
3060-0819_Explanation_for_FCC_Form_555_Non-substantitve_Change_October_24_2014_final.docx Justification for No Material/Nonsubstantive Change	2014-10-24
0819 Explanation of Non-Substantive Change_053014.docx Justification for No Material/Nonsubstantive Change	2014-06-11
0819_FCC Form-481-Instructions_061014.pdf Supplementary Document	2014-06-11
0819_FCC Form 418 (2014 Revision) for 3060-0986 and 3060-0819_053014.xlsx Supplementary Document	2014-06-11
0819_FCC Form 560_090412.doc Supplementary Document	2013-10-30
0819 Lifeline Form 555 Instructions_102413.docx Supplementary Document	2013-10-30
0819 Lifeline Form 555 Updated_101313.docx Supplementary Document	2013-10-30
0819_FCC Form 550_090412.doc Supplementary Document	2013-10-30
FCC Form481_ExcelSpreadsheet_052213_final.xlsx Supplementary Document	2013-10-30
0819_FCC Form 481 Instructions_072613.doc Supplementary Document	2013-10-30
0819_FCC Form 497_090412.docx Supplementary Document	2013-10-30
0819_Non_Substantive Changes_072613.doc Justification for No Material/Nonsubstantive Change	2013-07-25
0819 SS_102213 Final.doc Supporting Statement A	2013-10-30

IC Document Collections

IC ID	Document Title	Status
207916	FCC Form 481, 54.313/54.422 Data Collection Form Form	Unchanged
203943	All other reporting, recordkeeping and 3rd party requirements (except items 12a, e, p and q)	Unchanged
203942	FCC Form 560, Low Income Brodband Pilot Program Reporting Form Form and Instruction	Unchanged
203941	FCC Form 555, Annual Lifeline Eligible Telecommunications Carrier Certification Form Form and Instruction	Unchanged
201446	FCC Form 550, Low Income Broadband Pilot Program Reimbursement Form Form and Instruction	Unchanged
201445	FCC Form 497 and instructions - individuals or households Form and Instruction	Unchanged

ICR Details

OMB Control No: 3060-0819	ICR Reference No: 201504-3060-018
Status: Historical Active	Previous ICR Reference No: 201410-3060-011
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Lifeline and Link Up Reform and Modernization, Advancing Broadband Availability Through Digital Literacy Training and FCC Forms 481, 497, 550, 555 and 560
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: Approved without change	Conclusion Date: 05/06/2015
	Date Received in OIRA: 04/20/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	12/31/2016	12/31/2016
Responses	41,838,920	0	41,838,920
Time Burden (Hours)	24,184,565	0	24,184,565
Cost Burden (Dollars)	0	0	0

---

Abstract: The Commission is seeking a non-substantive change request to this information collection. This submission seeks to update FCC Form 555 and FCC Form 555 Instructions. The Commission adopted FCC 12-11, the Lifeline Reform Report and Order, which adopts rules which are intended to take immediate action to address potential waste, fraud,and abuse of the Universal Service low income program. Furthermore, in the Commission's attempt to reduce the number of information collections, we have removed and consolidated all low-income requirements into this submission. Upon OMB approval, the Commission will voluntarily discontinue OMB Control Number 3060-0774 so there is no duplication of reporting, recordkeeping and/or third party disclosure requirements. The Commission is seeking a non-substantive change request for this information collection. This submission seeks to update FCC Form 555 and the accompanying Instructions.

---

Authorizing Statute(s): US Code: 47 USC 201-205 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 1 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 4(i) 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 254 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 403 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-AF85	Final or interim final rulemaking	77 FR 12952	03/02/2012

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 52528	08/23/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 63467	10/24/2013
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
FCC Form 555, Annual Lifeline Eligible Telecommunications Carrier Certification Form	FCC Form 555	Annual Lifeline Eligibility Telecommunications Carrier Certification Form
FCC Form 481, 54.313/54.422 Data Collection Form	FCC Form 481	54.313/54.422 Data Collection Form
All other reporting, recordkeeping and 3rd party requirements (except items 12a, e, p and q)
FCC Form 560, Low Income Brodband Pilot Program Reporting Form	FCC Form 560	Low Income Broadband Pilot Program Reporting Form
FCC Form 550, Low Income Broadband Pilot Program Reimbursement Form	FCC Form 550	Low Income Broadband Pilot Program Reimbursement Form
FCC Form 497 and instructions - individuals or households	FCC Form 497	Lifeline Worksheet

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	41,838,920	41,838,920	0	0	0	0
Annual Time Burden (Hours)	24,184,565	24,184,565	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: The program changes that resulted in these burden changes include changes to: (1) the information required on FCC Form 555, consistent with the Commission's rules and orders, that increased the burden; and (2) various changes to other ICs that reduced the burden, and the elimination of the Broadband Pilot Program.

---

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: 04/20/2015

---