Information Collection

FCC Form 497

IC 218852 under ICR 201704-3060-017 · 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⚠️ Notice: This information collection may be referencing outdated material.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
3060-0819 Form 497 Field Descriptions_Final-Clean_7-12-16.docx	Other-FCC 497 Field Descriptions
FCC 497 Lifeline Worksheet 3060-0819 FCC Form 497 Instructions_Final_7-11-16.docx	Form and Instruction

IC Title:

FCC Form 497

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 54.400-54.423 47 CFR 54.201-54.207

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-FCC 497 Field Descriptions			3060-0819 Form 497 Field Descriptions_Final-Clean_7-12-16.docx		Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC 497	Lifeline Worksheet	3060-0819 FCC Form 497 Instructions_Final_7-11-16.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: FCC/WCB - 1, Lifeline Program

FR Citation: 78 FR 73535

Number of Respondents: 10,267,665

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11,664,231	-313,889	11,978,120
Annual IC Time Burden (Hours)	6,074,075	-668,131	6,742,206
Annual IC Cost Burden (Dollars)	468,750	0	468,750

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.