Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms

Forms and Documents

Document Name	Status
Form FCC Form 473 Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms Form	Modified
Multiple Collections Non Substantive Change Request (June 2016).doc Justification for No Material/Nonsubstantive Change	2016-06-24
3060-0856 SS (Revision Forms 472 473 474) (Final 2016).docx Supporting Statement A	2016-05-10

IC Document Collections

IC ID	Document Title	Status
31231	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms Form	Modified
191854	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	Unchanged

ICR Details

OMB Control No: 3060-0856	ICR Reference No: 201606-3060-022
Status: Historical Active	Previous ICR Reference No: 201604-3060-013
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms
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: 07/06/2016
	Date Received in OIRA: 06/24/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	06/30/2019	06/30/2019
Responses	168,900	0	168,900
Time Burden (Hours)	168,900	0	168,900
Cost Burden (Dollars)	0	0	0

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Abstract: This submission is being made for a non-substantive change request to existing information collections pursuant to 44 U.S.C. § 3507. The Commission seeks to change the Instructions to FCC Form 474 (3060-0856). The New Address for the Universal Service Administrative Company (USAC), starting July 12, 2016 will be 700 12th Street, NW, Suite 900, Washington, DC 20005. The form and instructions will be updated with the new address. There are no changes to the burdens hours or cost to this information collection. FCC Forms 472, 473, and 474 allow schools, libraries and service providers to seek reimbursement for E-rate discounts. The forms facilitate the E-rate funding reimbursement process by enabling USAC to confirm that service providers have actually provided the discounted services, verify the eligibility of the services for E-rate support, ensure that each service provider has provided discounted services within the current funding year, approve the amount that should be reimbursed, and confirm that service provider invoices do not exceed the amount that has been approved.

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Authorizing Statute(s): US Code: 47 USC 201-205 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 254 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 312(d), 312(f) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 403 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 503(b) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 4(i), 4(j) Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3060-AF85	Final or interim final rulemaking	79 FR 49160	08/19/2014

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 2216	01/15/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 29263	05/11/2016
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms
Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	FCC Form 474, FCC Form 472, FCC Form 473	Service Provider Annual Certification Form ,   Billed Entity Applicant Reimbursement Form ,   Service Provider Invoice Form

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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	168,900	168,900	0	0	0	0
Annual Time Burden (Hours)	168,900	168,900	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: 06/24/2016

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