State, Local or Tribal Government

Application for Connect America Fund Phase II and Rural Digital Opportunity Fund Auction Support

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-1256 can be found here:

Documents and Forms

Document Name Document Type
Form FCC Form 683 State, Local or Tribal Government Form
FCC Form 683 Rural Digital Opportunity Fund Long Form A904_Long_Form_06112020.docx Form

Information Collection (IC) Details

IC Title:	State, Local or Tribal Government	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 54.804 (c) 47 CFR 54.804 (b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 683	Rural Digital Opportunity Fund Long Form	A904_Long_Form_06112020.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 265	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	530	400	-270	400
Annual IC Time Burden (Hours)	3,710	2,800	-1,890	2,800
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.