Information Collection

Universal Service - Rural Health Care Program

IC 207576 under ICR 202002-3060-020 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Attachment 2_2020 Telecom Program Invoice for OMB submission.10.28.19_RHC.effective FY2020 04.03.20.docx Other-Invoice Form (FY2020)
Attachment 2_2020 Telecom Program Invoice for OMB submission.10.28.19_RHC.effective FY2021 and beyond (4.3.20).docx Other-Invoice Form (FY2021+)

Information Collection (IC) Details

View Information Collection (IC)

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 - 54.633

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Invoice Form (FY2021+)			Attachment 2_2020 Telecom Program Invoice for OMB submission.10.28.19_RHC.effective FY2021 and beyond (4.3.20).docx		Yes	Yes	Fillable Fileable Signable
Other-Invoice Form (FY2020)			Attachment 2_2020 Telecom Program Invoice for OMB submission.10.28.19_RHC.effective FY2020 04.03.20.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: 3,498	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	31,229	1,467	-9,252	39,014
Annual IC Time Burden (Hours)	127,581	31,257	4,627	91,697
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

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.