Information Collection

FCC Form 2100, Application for Media Bureau Audio and Video Service Authorization, Schedule H

IC 30840 under ICR 201911-3060-006 · OMB 3060-0754.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0754 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 2100 Sche FCC Form 2100, Application for Media Bureau Audio and Video Service Authorization, Schedule H	Form
FCC Form 2100 Sche Form 2100, Application for Media Bureau Audio and Video FCC Form 2100 Schedule H (2019) updated (November 2019)(final)- revised 12.10.19.docx	Form

IC Title:

FCC Form 2100, Application for Media Bureau Audio and Video Service Authorization, Schedule H

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 2100 Schedule H	Form 2100, Application for Media Bureau Audio and Video Service Authorization, Schedule H	FCC Form 2100 Schedule H (2019) updated (November 2019)(final)- revised 12.10.19.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,758

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,758	-6,946	8,704
Annual IC Time Burden (Hours)	17,580	-86,868	104,448
Annual IC Cost Burden (Dollars)	1,054,800	-4,167,600	5,222,400

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.