Federal Government

Reasonable Accommodation Requests, FCC Forms 5626 and 5627

OMB: 3060-1246

IC ID: 227967

Information Collection (IC) Details

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Federal Government OWD
No Modified
29 CFR 1615

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FCC Form 5626 Reasonable Accommodation Form with Questionnaire RA Form with Questionnaire 7.8_final.docx Yes Yes Fillable Fileable Signable

General Government Central Fiscal Operations

EEOC/GOVT-1, Equal Employment Opportunity (EEO), Complaint and Appeal Records  81 FR 81116

27 0
Federal Government
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 54 0 0 -6 0 60
Annual IC Time Burden (Hours) 142 0 0 -170 0 312
Annual IC Cost Burden (Dollars) 1,700 0 0 800 0 900

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