Information Collection Request

Certification by Administrative Authority to Billed Entity Compliance with the Children's Internet Protection Act Form; Certification of Compliance with the CIPA and Technology Plan Requirements Form;

ICR 201609-3060-003 · OMB 3060-0853 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form FCC 486 Receipt of Service Confirmation and Children’s Internet Protection Act and Technology Plan Certification Form Form Modified Available
Form FCC 479 Certification by Administrative Authority to Billed Entity of Compliance with the Children’s Internet Protection Act Form Modified Available
Form FCC 500 Funding Commitment Adjustment Request Form Form Modified Available
3060-0853 SS 2016 (final).doc Supporting Statement A Uploaded 2016-10-18 Available
FCC-14-99A1.pdf Supporting Statement B Uploaded 2016-09-23 Available
Multiple Collections Non Substantive Change Request (June 2016).doc Justification for No Material/Nonsubstantive Change Uploaded 2016-06-24 Available
3060-0853 Explanation of Non-Substantive Changes 2016.doc Justification for No Material/Nonsubstantive Change Uploaded 2016-05-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
31206 FCC Forms 479, 486 and 500 (business entities) Form ModifiedReceipt of Service Confirmation and Children’s Internet Protection Act and Technology Plan Certification Form
31206 FCC Forms 479, 486 and 500 (business entities) Instruction Modified
31206 FCC Forms 479, 486 and 500 (business entities) Form ModifiedCertification by Administrative Authority to Billed Entity of Compliance with the Children’s Internet Protection Act
207405 FCC Forms 479, 486 and 500 (state, local or tribal entities) Instruction Modified
207405 FCC Forms 479, 486 and 500 (state, local or tribal entities) Form ModifiedFunding Commitment Adjustment Request Form

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2019 36 Months From Approved 12/31/2016
63,700 0 90,700
58,575 0 104,650
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
FCC Forms 479, 486 and 500 (business entities) FCC 479, FCC 486 ,  
FCC Forms 479, 486 and 500 (state, local or tribal entities) FCC 500

table that charts list 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 63,700 90,700 0 -12,500 -14,500 0
Annual Time Burden (Hours) 58,575 104,650 0 -35,200 -10,875 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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