Information Collection

FCC Forms 555 and 481

IC 218853 under ICR 201606-3060-029 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Price Cap Screenshot 7-6-12 (7).docx	Other-Price Cap Screenshot
Copy of Price Cap Line 2024 Template (1).xlsx	Other-Price Cap Line 2024 Template
Copy of Price Cap Line 2025 Template (7).xlsx	Other-Price Cap Line 2025 Template
FCC Form 481 Instructions_Final_7-12-16.docx	Instruction
Lifeline Form 555 Field Descriptions_Final-Clean_7-12-16.docx	Other-Form 555 Field Desciptions
FCC Form 555 Instructions_Final_7-11-16.doc	Instruction
Copy of FCC Form 481 PDF Template_Final_7-12-16.xlsx	Other-Form 481 Template

IC Title:

FCC Forms 555 and 481

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.403 47 CFR 54.405(e)(4) 47 CFR 54.222 47 CFR 54.407 47 CFR 54.313 47 CFR 54.410(f) 47 CFR 54.416(b)

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Price Cap Screenshot	Price Cap Screenshot 7-6-12 (7).docx	Yes	Yes	Fillable Fileable Signable
Other-Price Cap Line 2024 Template	Copy of Price Cap Line 2024 Template (1).xlsx	Yes	Yes	Fillable Fileable Signable
Other-Price Cap Line 2025 Template	Copy of Price Cap Line 2025 Template (7).xlsx	Yes	Yes	Fillable Fileable Signable
Instruction	FCC Form 481 Instructions_Final_7-12-16.docx	Yes	Yes	Fillable Printable
Other-Form 555 Field Desciptions	Lifeline Form 555 Field Descriptions_Final-Clean_7-12-16.docx	Yes	Yes	Fillable Fileable Signable
Instruction	FCC Form 555 Instructions_Final_7-11-16.doc	Yes	Yes	Fillable Printable
Other-Form 481 Template	Copy of FCC Form 481 PDF Template_Final_7-12-16.xlsx	Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,581,130

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	11,978,120	-2,401,968	-890,873	15,270,961
Annual IC Time Burden (Hours)	6,742,206	-4,290,193	0	11,032,399
Annual IC Cost Burden (Dollars)	468,750	0	468,750	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.