Information Collection

Universal Service - Rural Health Care Program

IC 199666 under ICR 201904-3060-023 · OMB 3060-0804.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0804 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 460 Universal Service - Rural Health Care Program	Form and Instruction
FCC Form 460 RHC- Healthcare Connect Fund Program - Description of El 2019 FCC Form 460 for OMB submission.6.29.16.docx	Form and Instruction
FCC Form 461 RHC - Healthcare Connect Fund Program - Description of R 2019 FCC Form 461 for OMB submission.docx	Form and Instruction
FCC Form 462 RHC - Healthcare Connect Fund Program - Description of R 2019 FCC Form 462 for OMB submission.docx	Form and Instruction
FCC Form 463 RHC - Healthcare Connect Fund Program - Description of R 2019 FCC Form 463 for OMB submission.docx	Form and Instruction
FCC Form 465 RHC - Telecommunications Program - Description of Eligib 2019 FCC Form 465 for OMB submission.docx	Form and Instruction
FCC Form 466 RHC - Telecommunications Program - Description of Reques 2019 FCC Form 466 for OMB submission.docx	Form and Instruction
FCC Form 467 RHC - Telecommunications Program - Description of Reques 2019 FCC Form 467 for OMB submission.docx	Form and Instruction

IC Title:

Universal Service - Rural Health Care Program

Agency IC Tracking Number:

WCB

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.600 - 54.680

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FCC Form 460	RHC- Healthcare Connect Fund Program - Description of Eligibility and Registration	2019 FCC Form 460 for OMB submission.6.29.16.docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 461	RHC - Healthcare Connect Fund Program - Description of Request for Services	2019 FCC Form 461 for OMB submission.docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 462	RHC - Healthcare Connect Fund Program - Description of Request for Funding	2019 FCC Form 462 for OMB submission.docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 463	RHC - Healthcare Connect Fund Program - Description of Request for Funding Disbursement	2019 FCC Form 463 for OMB submission.docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 465	RHC - Telecommunications Program - Description of Eligibility and Request for Services	2019 FCC Form 465 for OMB submission.docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 466	RHC - Telecommunications Program - Description of Request for Funding	2019 FCC Form 466 for OMB submission.docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 467	RHC - Telecommunications Program - Description of Request for Funding Disbursement	2019 FCC Form 467 for OMB submission.docx	Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,771

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	39,014	-223	-6,711	45,948
Annual IC Time Burden (Hours)	91,697	-201	-4,586	96,484
Annual IC Cost Burden (Dollars)	0	0	0	0

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.