Information Collection

FCC Form 555, Annual Lifeline Eligible Telecommunications Carrier Certification Form

IC 203941 under ICR 201510-3060-007 · OMB 3060-0819.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0819 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 555 FCC Form 555, Annual Lifeline Eligible Telecommunications Carrier Certification Form	Form and Instruction
FCC Form 555 Annual Lifeline Eligibility Telecommunications Carrier C 0819_FCC555_Revised_091412.docx	Form and Instruction
FCC Form 555 Annual Lifeline Eligibility Telecommunications Carrier C 0819_FCC555_Revised_091412.docx	Form and Instruction

IC Title:

FCC Form 555, Annual Lifeline Eligible Telecommunications Carrier Certification Form

Agency IC Tracking Number:

WCB

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FCC Form 555	Annual Lifeline Eligibility Telecommunications Carrier Certification Form	0819_FCC555_Revised_091412.docx		Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 555	Annual Lifeline Eligibility Telecommunications Carrier Certification Form	0819_FCC555_Revised_091412.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 940

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 35 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-940	940
Annual IC Time Burden (Hours)	-15,040	15,040
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.