Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0856 can be found here:

Documents and Forms

Document Name Document Type
Form FCC Form 473 Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms Form
FCC Form 474 Service Provider Invoice Form 3060-0856 Form 474 5 3 16.docx Form
FCC Form 473 Service Provider Annual Certification Form 3060-0856 Form 473 5 3 16.docx Form
FCC Form 472 Billed Entity Applicant Reimbursement Form 3060-0856 Form 472 5 3 16.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Universal Service - Schools and Libraries Universal Service Program Reimbursement Forms	Agency IC Tracking Number:	WCB

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.516 47 CFR 54.520 47 CFR 54.508 47 CFR 54.504

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 473	Service Provider Annual Certification Form	3060-0856 Form 473 5 3 16.docx	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 472	Billed Entity Applicant Reimbursement Form	3060-0856 Form 472 5 3 16.docx	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 474	Service Provider Invoice Form	3060-0856 Form 474 5 3 16.docx	Yes	Yes	Fillable Fileable Signable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,350	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Previously Approved
Annual Number of Responses for this IC	84,450	84,450
Annual IC Time Burden (Hours)	84,450	84,450
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.