Annual Report for Mobility Fund Phase I Support, FCC Form 690 and Record Retention Requirements

Forms and Documents

Document Name	Status
Supporting Statement OMB 3060-1185 April 2019.doc Supporting Statement A	2019-04-11

IC Document Collections

IC ID	Document Title	Status
205578	Annual Report for Mobility Fund Phase I Support, FCC Form 690 and Record Retention Requirements Other-Screen Shots	Modified
205577	Annual Report for Mobility Fund Phase I Support, FCC Form 690 and Record Retention Requirements	Modified

ICR Details

OMB Control No: 3060-1185	ICR Reference No: 201904-3060-012
Status: Active	Previous ICR Reference No: 201603-3060-013
Agency/Subagency: FCC	Agency Tracking No: WTB/Mobility
Title: Annual Report for Mobility Fund Phase I Support, FCC Form 690 and Record Retention Requirements
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/22/2019
	Date Received in OIRA: 04/18/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2022	36 Months From Approved	05/31/2019
Responses	880	0	880
Time Burden (Hours)	15,874	0	15,874
Cost Burden (Dollars)	0	0	0

---

Abstract: This collection of information requires respondents to file annual reports with the Commission demonstrating the coverage provided with support from the Mobility Fund for five years after qualifying for support. Documentation prepared for, or in connection with, the award of Mobility Fund Phase I support is to be retained for a period of not less than 10 years after it receives the final disbursement of support. The Commission created new FCC Form 690 to ensure that recipients of Mobility Fund Phase I support are meeting their obligations for receiving support. The FCC Form 690, Annual Report for Mobility Fund Phase I Support, format is being modified as a result of the development of online electronic filings by both the Federal Communications Commission and Universal Service Administrative Company.

---

Authorizing Statute(s): US Code: 47 USC 154 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
  

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:
	84 FR 3168	02/11/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 16260	04/18/2019
Did the Agency receive public comments on this ICR? Yes

---

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

IC Title	Form No.	Form Name
Annual Report for Mobility Fund Phase I Support, FCC Form 690 and Record Retention Requirements
Annual Report for Mobility Fund Phase I Support, FCC Form 690 and Record Retention Requirements

---

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	880	880	0	0	0	0
Annual Time Burden (Hours)	15,874	15,874	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:

---

Annual Cost to Federal Government: $168,010

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: 04/18/2019

---