Lifeline and Link Up Reform and Modernization, Telecommunications Carriers Eligible for Universal Service Support, Connect America Fund.

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 481 Carrier Annual Reporting Data Collection Form	Form	Modified	Available
Form FCC Form 555 Description of Services Requested and Certification - Field Descriptions	Form	Modified	Available
Form FCC Form 5631 Lifeline Program Household Worksheet	Form	Modified	Available
Form FCC Form 5630 Lifeline Program Annual Recertification Form	Form	Modified	Available
Form FCC Form 5629 Lifeline Program Application Form	Form	Modified	Available
Form FCC Form 497 Lifeline Worksheet	Form and Instruction	Modified	Available
3060-0819 -Supporting Statement Modified Amounts NaLa Response (FINAL VERSION)_6.12.18.docx	Supporting Statement A	Uploaded 2018-06-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
218853	FCC Forms 555 and 481	Form	Modified	Carrier Annual Reporting Data Collection Form
218853	FCC Forms 555 and 481	Form	Modified	Description of Services Requested and Certification - Field Descriptions
218853	FCC Forms 555 and 481	Instruction	Modified
218852	FCC Form 497	Form	Modified	Lifeline Program Household Worksheet
218852	FCC Form 497	Form	Modified	Lifeline Program Annual Recertification Form
218852	FCC Form 497	Form	Modified	Lifeline Program Application Form
218852	FCC Form 497	Form and Instruction	Modified	Lifeline Worksheet

ICR Details

OMB Control No: 3060-0819	ICR Reference No: 201804-3060-015
Status: Historical Active	Previous ICR Reference No: 201711-3060-002
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Lifeline and Link Up Reform and Modernization, Telecommunications Carriers Eligible for Universal Service Support, Connect America Fund.
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/09/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/12/2018
Terms of Clearance: OMB approves this collection with the following terms of clearance: For the requirement that ETCs notify affected subscribers in writing about new substantive restrictions and ineligibility, the FCC must provide at least 30 days after the publication of the tool (that will allow Lifeline service providers to determine whether: (1) a subscriber residing on Tribal lands resides in a rural area, or (2) if a subscriber who lives on rural, Tribal lands currently receives service from a non-facilities-based provider), for ETCs to comply with this notification requirement.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2021	36 Months From Approved	12/31/2020
Responses	20,317,788	0	23,954,123
Time Burden (Hours)	10,972,641	0	11,028,571
Cost Burden (Dollars)	937,500	0	937,500

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Abstract: This revision implements the requirement that ETCs provide written notice to their customers who are currently receiving enhanced support who will no longer be eligible for enhanced Tribal support. In addition, the Commission seeks to update the number of respondents for most of the existing information collection requirements, thus increasing the total burden hours for some requirements and decreasing the total burden hours for other requirements.

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Authorizing Statute(s): US Code: 47 USC 1, 4(i), 5 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 201, 205, 214, 219-220, 254 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 303(r), 403, 1302 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 706 Name of Law: Communications Act of 1996, as amended
   US Code: 47 USC 151, 154, 155 Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3060-AK57	Final or interim final rulemaking	83 FR 2075	01/16/2018

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 13484	03/29/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 27328	06/12/2018
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
FCC Form 497	FCC Form 497, FCC Form 5630, FCC Form 5631, FCC Form 5629	Lifeline Worksheet ,   Lifeline Program Application Form ,   Lifeline Program Annual Recertification Form ,   Lifeline Program Household Worksheet
FCC Forms 555 and 481	FCC Form 555, FCC Form 481	Description of Services Requested and Certification - Field Descriptions ,   Carrier Annual Reporting Data Collection Form

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ICR Summary of Burden

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	20,317,788	23,954,123	0	133	-3,636,468	0
Annual Time Burden (Hours)	10,972,641	11,028,571	0	133	-56,063	0
Annual Cost Burden (Dollars)	937,500	937,500	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: . This update reflects program changes associated with ETCs being required to notify customers who are no longer eligible for enhanced Tribal support. This will lead to an increase to the total number of respondents and responses by 133, and burden increase of 133 hours for ETCs. Also, the Commission is reporting adjustments to this information collection, which are due to an update in the number of respondents. For these adjustments, the total number of respondents decreased by 2,546,515 respondents, the total number of annual responses decreased by 3,636,335, and the total annual burden hours decreased by 55,930 hours. These adjustments are due to the Commission re-evaluating the previous figures used in this collection to better reflect experience in administrating the collections.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/12/2018

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