Certification by Administrative Authority to Billed Entity Compliance with the Children's Internet Protection Act Form; Certification of Compliance with the CIPA and Technology Plan Requirements Form;

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC 500 Funding Commitment Adjustment Request Form	Form	Modified	Available
Form FCC 486 Receipt of Service Confirmation and Children's Internet Protection Act and Technology Plan Certification	Form	Modified	Available
Form FCC 500 Funding Commitment Adjustment Request Form	Form	Modified	Repair queued
Form FCC 486 Receipt of Service Confirmation and Children's Internet Protection Act and Technology Plan Certification Form	Form	Modified	Available
Form FCC 479 Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act	Form	Modified	Repair queued
Form FCC 500 Funding Commitment Adjustment Request Form	Form	Unchanged	Repair queued
Form FCC 486 Receipt of Service Confirmation and Children's Internet Protection Act and Technology Plan Certification Form	Form	Unchanged	Available
Form FCC 479 Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act	Form	Unchanged	Available
3060-0853 Explanation of Non-Substantive Changes 2016.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2016-05-16	Available
0853_Nonsubstantive ChangeAbstract_122713_final.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2013-12-27	Available
0853 FCC Form 486_110713.doc	Supplementary Document	Uploaded 2013-11-07	Available
0853 FCC Form 486_102513.doc	Supplementary Document	Uploaded 2013-11-05	Repair queued
0853 FCC Form 486_102513.doc	Supplementary Document	Uploaded 2013-11-05	Repair queued
0853 Instructions FCC Form 500 Final 2013_102813.docx	Supplementary Document	Uploaded 2013-10-28	Available
0853 FCC Form 500 Final_102813.doc	Supplementary Document	Uploaded 2013-10-28	Repair queued
0853 Instructions FCC Form 486 Final_102813.docx	Supplementary Document	Uploaded 2013-10-28	Available
0853 FCC Form 486_093013.doc	Supplementary Document	Uploaded 2013-10-28	Repair queued
0853 FCC Form 479 Final_102813.doc	Supplementary Document	Uploaded 2013-10-28	Available
0853 Instructions FCC Form 479 Final_093013.docx	Supplementary Document	Uploaded 2013-10-28	Available
0853 SS Revision_101713.doc	Supporting Statement A	Uploaded 2013-10-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
31206	FCC Forms 479, 486 and 500 (business entities)	Form	Modified	Funding Commitment Adjustment Request Form
31206	FCC Forms 479, 486 and 500 (business entities)	Form	Modified	Receipt of Service Confirmation and Children's Internet Protection Act and Technology Plan Certification
31206	FCC Forms 479, 486 and 500 (business entities)	Form	Modified	Funding Commitment Adjustment Request Form
31206	FCC Forms 479, 486 and 500 (business entities)	Form	Modified	Receipt of Service Confirmation and Children's Internet Protection Act and Technology Plan Certification Form
31206	FCC Forms 479, 486 and 500 (business entities)	Form	Modified	Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act
31206	FCC Forms 479, 486 and 500 (business entities)	Instruction	Modified
207405	FCC Forms 479, 486 and 500 (state, local or tribal entities)	Form	Unchanged	Funding Commitment Adjustment Request Form
207405	FCC Forms 479, 486 and 500 (state, local or tribal entities)	Form	Unchanged	Receipt of Service Confirmation and Children's Internet Protection Act and Technology Plan Certification Form
207405	FCC Forms 479, 486 and 500 (state, local or tribal entities)	Form	Unchanged	Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act
207405	FCC Forms 479, 486 and 500 (state, local or tribal entities)	Instruction	Unchanged

ICR Details

OMB Control No: 3060-0853	ICR Reference No: 201605-3060-008
Status: Historical Active	Previous ICR Reference No: 201312-3060-014
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Certification by Administrative Authority to Billed Entity Compliance with the Children's Internet Protection Act Form; Certification of Compliance with the CIPA and Technology Plan Requirements Form;
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: 05/23/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/16/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	12/31/2016	12/31/2016
Responses	90,700	0	90,700
Time Burden (Hours)	104,650	0	104,650
Cost Burden (Dollars)	0	0	0

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Abstract: This submission is being made for a non-substantive change request to an existing information collection pursuant to 44 U.S.C. § 3507. The Commission seeks to update FCC Forms 486 and 500 to move the forms onto a new information (IT) technology platform. The three FCC forms (FCC Forms 479, 486, and 500) serve the functions of the Universal Service Schools and Libraries Support Mechanism (47 U.S.C. Section 254, et seq.). They are used at the point where services provided pursuant to the Program are implemented; or about to be implemented and are a necessary prerequisite to the distribution of payments under the Program. The forms ensure that congressional mandates regarding access to the Internet by minors are met. The Federal Communication Commission is seeking OMB approval for a revision. The FCC revised the FCC Forms 479, 486 and 500 instructions. FCC Form 479 and 486 include revisions to existing certifications to improve clarity and ensure consistency with FCC rules. FCC Form 500 includes revisions that allow applicants the option to use the FCC Form 500 to: 1) seek extension of the implementation deadline for non-recurring services from USAC under 47 CFR 54.507(d); and/or 2) notify USAC when they are transferring equipment within the 3 year prohibition on equipment transfers due to a permanent or temporary closure of school or library facilities under 47 CFR 54.413 of the Commission's rules.

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Authorizing Statute(s): US Code: 47 USC 254 Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: PL: Pub.L. 106 - 554 215 Name of Law: Children's Internet Protection Act (CIPA)

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 40476	07/05/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 63467	10/24/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
FCC Forms 479, 486 and 500 (business entities)	FCC 500, FCC 486, FCC 479, FCC 486, FCC 500	Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act ,   Receipt of Service Confirmation and Children's Internet Protection Act and Technology Plan Certification Form ,   Funding Commitment Adjustment Request Form ,   Receipt of Service Confirmation and Children's Internet Protection Act and Technology Plan Certification ,   Funding Commitment Adjustment Request Form
FCC Forms 479, 486 and 500 (state, local or tribal entities)	FCC 479, FCC 486, FCC 500	Certification by Administrative Authority to Billed Entity of Compliance with the Children's Internet Protection Act ,   Receipt of Service Confirmation and Children's Internet Protection Act and Technology Plan Certification Form ,   Funding Commitment Adjustment Request Form

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ICR Summary of Burden

table that charts list 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	90,700	90,700	0	0	0	0
Annual Time Burden (Hours)	104,650	104,650	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:

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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

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Common Form ICR:  No

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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: 05/16/2016

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