Information Collection

Universal Service - Rural Health Care Program

IC 207576 under ICR 201606-3060-028 · OMB 3060-0804.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0804 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC 460 RHCP Description of Eligibility and Registration Universal Service - Rural Health Care Program	Form
Form Form 461 RHCP Description of Request for Services Universal Service - Rural Health Care Program	Form
Form Form 462 RHCP Description of Request for Funding Universal Service - Rural Health Care Program	Form
Form Form 463 RHCP Description of Request for Funding Disbursement Universal Service - Rural Health Care Program	Form
Form Form 465 RHCTP Description of Eligibility and Request for Services Universal Service - Rural Health Care Program	Form
Form Form 466 RHCTP Description of Request for Funding Universal Service - Rural Health Care Program	Form
Form Form 467 RHCTP Description of Request for Fundiing Disbursement Universal Service - Rural Health Care Program	Form
FCC 460 RHCP Description of Eligibility and Registration 2017 FCC Form 460 for OMB submission 6 29 16.pdf	Form
Form 461 RHCP Description of Request for Services 2017 FCC Form 461 for OMB submission 6 29 16.pdf	Form
Form 462 RHCP Description of Request for Funding 2017 FCC Form 462 for OMB submission 6 29 16.pdf	Form
Form 463 RHCP Description of Request for Funding Disbursement 2017 FCC Form 463 for OMB submission 6 29 16.pdf	Form
Form 465 RHCTP Description of Eligibility and Request for Service 2017 FCC Form 465 for OMB submission 6 29 16.pdf	Form
Form 466 RHCTP Description of Request for Funding 2017 FCC Form 466 for OMB submission 6 29 16.pdf	Form
Form 467 RHCTP Description of Request for Fundiing Disbursement 2017 FCC Form 467 for OMB submission 6 29 16.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Universal Service - Rural Health Care Program

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 54.600 - 54.680

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC 460	RHCP Description of Eligibility and Registration	2017 FCC Form 460 for OMB submission 6 29 16.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 461	RHCP Description of Request for Services	2017 FCC Form 461 for OMB submission 6 29 16.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 462	RHCP Description of Request for Funding	2017 FCC Form 462 for OMB submission 6 29 16.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 463	RHCP Description of Request for Funding Disbursement	2017 FCC Form 463 for OMB submission 6 29 16.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 465	RHCTP Description of Eligibility and Request for Services	2017 FCC Form 465 for OMB submission 6 29 16.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 466	RHCTP Description of Request for Funding	2017 FCC Form 466 for OMB submission 6 29 16.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 467	RHCTP Description of Request for Fundiing Disbursement	2017 FCC Form 467 for OMB submission 6 29 16.pdf	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,494

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	45,948	10,136	17,801	18,011
Annual IC Time Burden (Hours)	96,484	19,050	55,589	21,845
Annual IC Cost Burden (Dollars)	0	0	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.