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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.