Bridging the Digital Divide for Low-Income Consumers, Lifeline and Link Up Reform and Modernization, Telecommunications Carriers Eligible for Universal Service Support

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 5631 Lifeline Household Worksheet	Form	Modified	Available
Form FCC Form 5630 Lifeline Annual Re-certification Application Form	Form	Modified	Repair queued
Form FCC 497 Lifeline Worksheet	Form and Instruction	Modified	Available
Form FCC Form 5629 Lifeline Application Universal Form	Form	Modified	Available
3060-0819 NSC (120920).docx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-12-10	Available
3060-0819 -Supporting Statement Revisions_final version .docx	Supporting Statement A	Uploaded 2020-04-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
218853	Businesses or other for-profit	Form	Modified	Lifeline Household Worksheet
218853	Businesses or other for-profit	Form	Modified	Lifeline Annual Re-certification Application Form
218852	Individuals or Households	Form and Instruction	Modified	Lifeline Worksheet
218852	Individuals or Households	Form	Modified	Lifeline Application Universal Form
218852	Individuals or Households	Other-Form Change Memo	Modified

ICR Details

OMB Control No: 3060-0819	ICR Reference No: 202012-3060-004
Status: Historical Active	Previous ICR Reference No: 202004-3060-007
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Bridging the Digital Divide for Low-Income Consumers, Lifeline and Link Up Reform and Modernization, Telecommunications Carriers Eligible for Universal Service Support
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/15/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/10/2020
Terms of Clearance: OMB approves this collection with the following terms of clearance: For the requirement that ETCs notify affected subscribers in writing about new substantive restrictions and ineligibility, the FCC must provide at least 30 days after the publication of the tool (that will allow Lifeline service providers to determine whether: (1) a subscriber residing on Tribal lands resides in a rural area, or (2) if a subscriber who lives on rural, Tribal lands currently receives service from a non-facilities-based provider), for ETCs to comply with this notification requirement.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2023	06/30/2023	06/30/2023
Responses	20,102,235	0	20,102,235
Time Burden (Hours)	8,531,854	0	8,531,854
Cost Burden (Dollars)	937,500	0	937,500

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Abstract: This submission is being made for a non-substantive change to an existing information collection pursuant to 44 U.S.C. § 3507. The Commission inadvertently omitted FCC Forms 497, 5631, and field descriptions for Form 481 in its submission which was approved by the Office of Management and Budget (OMB) on June 15, 2020. We request that the current FCC Forms 481, 497, and 5631 be included in the 3060-0819 Information Collection approved by OMB on June 15, 2020. Revisions to FCC Form 481 were approved under OMB Control Number 3060-0986 (Notice of OMB Action received June 15, 2020), and the revised form was inadvertently omitted from this collection. Although the revision to this collection approved by OMB in June referenced updated burden estimates for Form 481, the revised form was not included with the submission. Similarly, the revisions to this collection referenced the updated burden estimates for FCC Forms 497 and 5631. However, the forms were not included with the submission. There were no substantive changes to the forms. We request that the omitted forms be uploaded so there is a complete inventory of the forms associated with this collection. This revision implements the requirements of the 2019 Lifeline Order. The Commission provides updates to the number of respondents for most of the existing information collection requirements, thus increasing the total burden hours for some requirements and decreasing the total burden hours for other requirements. The Commission is also making revisions to remove references to the LBP designation process and revisions to reflect process changes for enrollment representative registration and ETC biannual audits.

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Authorizing Statute(s): US Code: 47 USC 1, 4(i), 5 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 303(r), 403, 1302 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 706 Name of Law: Communications Act of 1996, as amended
   US Code: 47 USC 151, 154, 155 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 201, 205, 214, 219-220, 254 Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3060-AK57	Final or interim final rulemaking	84 FR 71308	12/27/2019

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 9765	02/20/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 23826	04/29/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Businesses or other for-profit	FCC Form 5630, FCC Form 5631	Lifeline Annual Re-certification Application Form ,   Lifeline Household Worksheet
Individuals or Households	FCC Form 5629, FCC 497	Lifeline Application Universal Form ,   Lifeline Worksheet

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	20,102,235	20,102,235	0	0	0	0
Annual Time Burden (Hours)	8,531,854	8,531,854	0	0	0	0
Annual Cost Burden (Dollars)	937,500	937,500	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Commission is reporting program changes to this information collection as a result of the 2019 Lifeline Order. The total number of respondents increased by 787,932 (from 17,547,843 to 18,335,775 respondents), the total number of annual responses decreased by -5,043,268 (from 20,317,788 to 15,274,520 responses), and the total annual burden hours decreased by -5,385,594 (from 10,972,641 to 5,587,047 hours). The Commission also has adjustments to this information collection which are due to the Commission re-evaluating the previous figures used in this collection to better reflect experience in administrating the collections. For these adjustments, the total number of annual responses increased by +4,827,715 (from 15,274,520 to 20,102,235 responses), and the total annual burden hours increased by +2,944,807 (from 5,587,047 to 8,531,854 hours, of this 8,531,854)(of the +2,944,807 hours adjustments of +36 hours are due to a miscalculation in the burden hours from the 2018 submission to OMB).

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/10/2020

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