FCC Forms 479, 486 and 500 (business entities)

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;

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0853 can be found here:

Documents and Forms

Document Name Document Type
Form FCC 479 FCC Forms 479, 486 and 500 (business entities) Form
0853 Instructions FCC Form 479 (10 6 16).docx Instruction
0853 Instructions FCC Form 486 (FY2015 and earlier) (10 6 2016).docx Instruction
FCC Form 486 Form Table (FY 2016 and later) (10 6 16).docx Other-Screenshot
FCC 479 Certification by Administrative Authority to Billed Enti 0853 FCC Form 479 (10 6 16).doc Form
FCC 486 Receipt of Service Confirmation and Children’s Internet 0853 FCC Form 486 (FY2015 and earlier)(10 6 16).doc Form

Information Collection (IC) Details

IC Title:	FCC Forms 479, 486 and 500 (business entities)	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 54.508(c) 47 CFR 54.507(d) 47 CFR 54.513 47 CFR 54.520 47 CFR 54.516

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC 479	Certification by Administrative Authority to Billed Entity of Compliance with the Children’s Internet Protection Act	0853 FCC Form 479 (10 6 16).doc	Yes	Yes	Fillable Fileable Signable
Instruction			0853 Instructions FCC Form 479 (10 6 16).docx	Yes	Yes	Fillable Printable
Form	FCC 486	Receipt of Service Confirmation and Children’s Internet Protection Act and Technology Plan Certification Form	0853 FCC Form 486 (FY2015 and earlier)(10 6 16).doc	Yes	Yes	Fillable Fileable Signable
Instruction			0853 Instructions FCC Form 486 (FY2015 and earlier) (10 6 2016).docx	Yes	Yes	Fillable Printable
Other-Screenshot			FCC Form 486 Form Table (FY 2016 and later) (10 6 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: 31,850	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 65 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	31,850	-6,250	-7,250	45,350
Annual IC Time Burden (Hours)	29,287	-17,601	-5,437	52,325
Annual IC Cost Burden (Dollars)	0	0	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.