Application for an FM Translator or FM Booster Station License, FCC Form 350

Forms and Documents

Document Name	Status
Form FCC Form 350 Application for an FM Translator or FM Booster Station License Form and Instruction	Modified
Form FCC Form 350 Application for an FM Translator or FM Booster Station License Form and Instruction	Modified
Supporting Statement OMB 3060-0404 2018.doc Supporting Statement A	2019-01-31

IC Document Collections

IC ID	Document Title	Status
30086	Application for an FM Translator or FM Booster Station License Form and Instruction	Modified
183777	Application for an FM Translator or FM Booster Station License Form and Instruction	Modified

ICR Details

OMB Control No: 3060-0404	ICR Reference No: 201901-3060-011
Status: Historical Active	Previous ICR Reference No: 201605-3060-011
Agency/Subagency: FCC	Agency Tracking No: MB
Title: Application for an FM Translator or FM Booster Station License, FCC Form 350
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Delegated
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/31/2019
	Date Received in OIRA: 01/31/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2022	36 Months From Approved	05/31/2019
Responses	500	0	350
Time Burden (Hours)	500	0	350
Cost Burden (Dollars)	37,500	0	26,250

---

Abstract: FCC Form 350 is required to be filed when applying for an FM Translator or FM Booster station license. The data is used by FCC staff to confirm that the station has been built to terms specified in the outstanding construction permit and for issuance of the license to operate the station.

---

Authorizing Statute(s): US Code: 47 USC 154(i), 307, 308 and 309 Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 56841	11/14/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 56841	11/14/2018
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Application for an FM Translator or FM Booster Station License	FCC Form 350	Application for an FM Translator or FM Booster Station License
Application for an FM Translator or FM Booster Station License	FCC Form 350	Application for an FM Translator or FM Booster Station License

---

ICR Summary 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	500	350	0	0	150	0
Annual Time Burden (Hours)	500	350	0	0	150	0
Annual Cost Burden (Dollars)	37,500	26,250	0	0	11,250	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: There are no program changes to this collection. There are adjustments/increases to the previously approved figures as follows: 150 to the number of respondents, 150 to the annual number of responses, 150 to the annual burden hours and $11,250 to the annual cost.

---

Annual Cost to Federal Government: $31,368

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.     No

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.     No

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

---

Common Form ICR:  No

---

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: 01/31/2019

---