Information Collection

Universal Service - Rural Health Care Program

IC 207576 under ICR 202102-3060-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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 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+)
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+)
Telecom Program Invoice 2.3.21 (clean).docx	Other-Telecom Program Invoice FY2021
Telecom Program Invoice 2.3.21 (clean).docx	Other-Telecom Program Invoice FY2021

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:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
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
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-Telecom Program Invoice FY2021+	Telecom Program Invoice 2.3.21 (clean).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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	31,229	31,229
Annual IC Time Burden (Hours)	127,581	127,581
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.