Information Collection

Business or other for-profit

IC 247348 under ICR 202105-3060-007 · OMB 3060-1286.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-1286 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 471 Business or other for-profit	Form
3060-xxxx FCC 21-58 Emergency Connectivity Fund Request for Reimbursement (FCC Forms 472-474) (5.12.2021).docx	Other-Screenshot - Request for Reimb
3060-xxxx FCC 21-58 Emergency Connectivity Fund Request for Reimbursement (FCC Forms 472-474) (5.12.2021).docx	Other-Screenshot - Request for Reimb
3060-xxxx FCC 21-58 Emergency Connectivity Fund Post-Commitment Change Request (5.12.2021).docx	Other-Screenshot - Post Commitment C
3060-xxxx FCC 21-58 Emergency Connectivity Fund Post-Commitment Change Request (5.12.2021).docx	Other-Screenshot - Post Commitment C
FCC Form 471 Description of Services Requested and Certification ECF 3060-xxxx FCC 21-58 Emergency Connectivity Fund FCC Form 471 (5.12.2021).docx	Form
FCC Form 471 Description of Services Requested and Certification ECF 3060-xxxx FCC 21-58 Emergency Connectivity Fund FCC Form 471 (5.12.2021).docx	Form

IC Title:

Business or other for-profit

Agency IC Tracking Number:

WCB

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.1710(a)-(b) 47 CFR 54.1711(a)-(b)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 471	Description of Services Requested and Certification ECF	3060-xxxx FCC 21-58 Emergency Connectivity Fund FCC Form 471 (5.12.2021).docx	Yes	Yes	Fillable Fileable Signable
Other-Screenshot - Request for Reimbursement (ECF)			3060-xxxx FCC 21-58 Emergency Connectivity Fund Request for Reimbursement (FCC Forms 472-474) (5.12.2021).docx	Yes	Yes	Fillable Fileable Signable
Other-Screenshot - Post Commitment Change Request (ECF)			3060-xxxx FCC 21-58 Emergency Connectivity Fund Post-Commitment Change Request (5.12.2021).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: 11,500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	66,050	66,050
Annual IC Time Burden (Hours)	157,725	157,725
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.