Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 499-A 2019 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2018 Revenues)	Form	Modified	Available
Form FCC 499 FCC Form 499-Q Telecommunications Reporting Worksheet	Form	Modified	Available
Form FCC Form 499-Q Telecommunications Reporting Worksheet Quarterly Filing for Universal Service Contributors	Form	Modified	Available
Form FCC Form 499-A 2018 Telecommunications Reporting Worksheet (Reporting 2017 Revenues)	Form	Modified	Repair queued
0855_Explanation_of_Non-Substantive_Changes_final_2.11.19.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2019-02-11	Available
0855_Explanation_of_Non-Substantive_Changes 1.18.18.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2018-01-18	Available
3060-0855 SS 112017.docx	Supporting Statement A	Uploaded 2017-11-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
188198	Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q	Form	Modified	2019 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2018 Revenues)
188198	Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q	Form	Modified	FCC Form 499-Q Telecommunications Reporting Worksheet
188198	Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q	Form	Modified	Telecommunications Reporting Worksheet Quarterly Filing for Universal Service Contributors
188198	Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q	Form	Modified	2018 Telecommunications Reporting Worksheet (Reporting 2017 Revenues)
188198	Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q	Instruction	Modified

ICR Details

OMB Control No: 3060-0855	ICR Reference No: 201902-3060-010
Status: Historical Active	Previous ICR Reference No: 201801-3060-007
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/12/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/11/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2020	12/31/2020	12/31/2020
Responses	41,650	0	41,650
Time Burden (Hours)	247,375	0	247,375
Cost Burden (Dollars)	0	0	0

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Abstract: This submission is being made for a non-substantive change request to an existing information collection pursuant to 44 U.S.C. § 3507. This submission seeks to update (i) FCC Form 499-A; (ii) the accompanying instructions to FCC Form 499-A; (iii) FCC Form 499-Q; and (iv) the accompanying instructions to FCC Form 499-Q. On December 21, 2018, the Commission issued a Public Notice seeking comment on the proposed changes (DA 18-1298). This submission is being made for a non-substantive change request to an existing information collection pursuant to 44 U.S.C. § 3507. This submission seeks to update (i) FCC Form 499-A; (ii) the accompanying instructions to FCC Form 499-A; (iii) FCC Form 499-Q; and (iv) the accompanying instructions to FCC Form 499-Q. The Federal Communications Commission (Commission) requires telecommunications carriers and other providers of telecommunications to contribute to the universal service fund and other funds. Contribution revenue data, as well as other information, are reported by carriers on FCC Forms 499-A (annual) and 499-Q (quarterly). Accompanying these forms are instructions on how to report revenue.

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Authorizing Statute(s): US Code: 47 USC 157 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 201 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 159 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 151 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 155 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 205 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 214 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 225 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 254 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 303(r) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 616 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(j) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(i) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 620 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:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 39998	08/23/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 51251	11/03/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q	FCC Form 499-A, FCC Form 499-Q, FCC Form 499-A, FCC 499	2018 Telecommunications Reporting Worksheet (Reporting 2017 Revenues) ,   Telecommunications Reporting Worksheet Quarterly Filing for Universal Service Contributors ,   FCC Form 499-Q Telecommunications Reporting Worksheet ,   2019 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2018 Revenues)

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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	41,650	41,650	0	0	0	0
Annual Time Burden (Hours)	247,375	247,375	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	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:

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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.     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

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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: 02/11/2019

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