Information Collection

Universal Service - Rural Health Care Program

IC 31049 under ICR 202105-3060-014 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form FCC Form 460 Universal Service - Rural Health Care Program	Form and Instruction
FCC Form 460 RHC, HCFP, Description of Eligibility and Registration 2020 FCC Form 460 for OMB submission.11.7.19_RHC.effective upon OMB approval (4.3.20).docx	Form and Instruction
FCC Form 460 RHC, HCFP, Description of Eligibility and Registration 2020 FCC Form 460 for OMB submission.11.7.19_RHC.effective upon OMB approval (4.3.20).docx	Form and Instruction
FCC Form 461 RHC, HFCP, Description of Request for Services (FY2020) 2020 FCC Form 461 for OMB submission.11.7.19_RHC.effective FY2020 (4.3.20).docx	Form and Instruction
FCC Form 461 RHC, HFCP, Description of Request for Services (FY2020) 2020 FCC Form 461 for OMB submission.11.7.19_RHC.effective FY2020 (4.3.20).docx	Form and Instruction
FCC Form 463 RHC, HCFP, Description of Request for Funding Disburseme 2020 FCC Form 463 for OMB submission.effective FY2020.11.7.19 (4.7.20).docx	Form and Instruction
FCC Form 463 RHC, HCFP, Description of Request for Funding Disburseme 2020 FCC Form 463 for OMB submission.effective FY2020.11.7.19 (4.7.20).docx	Form and Instruction
FCC Form 463 RHC, HCFP, Description of Request for Funding Disburseme 2020 FCC Form 463 for OMB submission.effective FY2021.11.7.19 (4.7.20) .docx	Form and Instruction
FCC Form 463 RHC, HCFP, Description of Request for Funding Disburseme 2020 FCC Form 463 for OMB submission.effective FY2021.11.7.19 (4.7.20) .docx	Form and Instruction
FCC Form 465 RHC, Telecommunications Program, Description of Eligibil 2020 FCC Form 465 for OMB submission.11.7.19_RHC.effective FY2020 (4.3.20).docx	Form and Instruction
FCC Form 465 RHC, Telecommunications Program, Description of Eligibil 2020 FCC Form 465 for OMB submission.11.7.19_RHC.effective FY2020 (4.3.20).docx	Form and Instruction
FCC Form 465 RHC, Telecommunications Program Description of Eligibili 2020 FCC Form 465 for OMB submission.11.7.19_RHC.effective FY2021 and beyond (4.3.20).docx	Form and Instruction
FCC Form 465 RHC, Telecommunications Program Description of Eligibili 2020 FCC Form 465 for OMB submission.11.7.19_RHC.effective FY2021 and beyond (4.3.20).docx	Form and Instruction
FCC Form 466 RHC, Telecommunications Program Description of Request f 2020 FCC Form 466 for OMB submission.11.7.19_RHC.effective FY2020 (4.3.20).docx	Form and Instruction
FCC Form 466 RHC, Telecommunications Program Description of Request f 2020 FCC Form 466 for OMB submission.11.7.19_RHC.effective FY2020 (4.3.20).docx	Form and Instruction
FCC Form 466 RHC, Telecommunications Program, Description of Request 2020 FCC Form 466 for OMB submission.11.7.19_RHC.effective FY2021 and beyond (4.3.20).docx	Form and Instruction
FCC Form 466 RHC, Telecommunications Program, Description of Request 2020 FCC Form 466 for OMB submission.11.7.19_RHC.effective FY2021 and beyond (4.3.20).docx	Form and Instruction
FCC Form 461 RHC, HCFP, Description of Request for Services (FY2021+) 2020 FCC Form 461 for OMB submission.11.7.19_RHC.effective FY2021 and beyond (4.3.20).docx	Form and Instruction
FCC Form 461 RHC, HCFP, Description of Request for Services (FY2021+) 2020 FCC Form 461 for OMB submission.11.7.19_RHC.effective FY2021 and beyond (4.3.20).docx	Form and Instruction
FCC Form 462 RHC, HCFP, Description of Request for Funding (FY2020+) 2020 FCC Form 462 for OMB submission.11.7.19_RHC.effective FY2020 and beyond (4.3.20).docx	Form and Instruction
FCC Form 462 RHC, HCFP, Description of Request for Funding (FY2020+) 2020 FCC Form 462 for OMB submission.11.7.19_RHC.effective FY2020 and beyond (4.3.20).docx	Form and Instruction
FCC Form 467 RHC, Telecommunications Program, Connection Certificatio 2020 FCC Form 467 for OMB submission.11.7.19_RHC.effective FY2020 and beyond (4.3.20).docx	Form and Instruction
FCC Form 467 RHC, Telecommunications Program, Connection Certificatio 2020 FCC Form 467 for OMB submission.11.7.19_RHC.effective FY2020 and beyond (4.3.20).docx	Form and Instruction
FCC Form 463 RHC-HCF-Description of Request for Funding Disbursement 2021 FCC Form 463 - 2.3.21 (clean) v2.docx	Form and Instruction
FCC Form 463 RHC-HCF-Description of Request for Funding Disbursement 2021 FCC Form 463 - 2.3.21 (clean) v2.docx	Form and Instruction
FCC Form 466 RHC, Telecommunications Program, Description of Request 2020 FCC Form 466_FY 2022+_5.27.21.docx	Form and Instruction
FCC Form 466 RHC, Telecommunications Program, Description of Request 2020 FCC Form 466_FY 2022+_5.27.21.docx	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

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	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FCC Form 460	RHC, HCFP, Description of Eligibility and Registration	2020 FCC Form 460 for OMB submission.11.7.19_RHC.effective upon OMB approval (4.3.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 461	RHC, HFCP, Description of Request for Services (FY2020)	2020 FCC Form 461 for OMB submission.11.7.19_RHC.effective FY2020 (4.3.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 463	RHC, HCFP, Description of Request for Funding Disbursement (FY2020)	2020 FCC Form 463 for OMB submission.effective FY2020.11.7.19 (4.7.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 463	RHC, HCFP, Description of Request for Funding Disbursement (FY2021+)	2020 FCC Form 463 for OMB submission.effective FY2021.11.7.19 (4.7.20) .docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 465	RHC, Telecommunications Program, Description of Eligibility and Request for Services (FY2020)	2020 FCC Form 465 for OMB submission.11.7.19_RHC.effective FY2020 (4.3.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 465	RHC, Telecommunications Program Description of Eligibility and Request for Services (FY 2021+)	2020 FCC Form 465 for OMB submission.11.7.19_RHC.effective FY2021 and beyond (4.3.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 466	RHC, Telecommunications Program Description of Request for Funding (FY2020)	2020 FCC Form 466 for OMB submission.11.7.19_RHC.effective FY2020 (4.3.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 466	RHC, Telecommunications Program, Description of Request for Funding (FY2021+)	2020 FCC Form 466 for OMB submission.11.7.19_RHC.effective FY2021 and beyond (4.3.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 461	RHC, HCFP, Description of Request for Services (FY2021+)	2020 FCC Form 461 for OMB submission.11.7.19_RHC.effective FY2021 and beyond (4.3.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 462	RHC, HCFP, Description of Request for Funding (FY2020+)	2020 FCC Form 462 for OMB submission.11.7.19_RHC.effective FY2020 and beyond (4.3.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 467	RHC, Telecommunications Program, Connection Certification Form (FY2020+)	2020 FCC Form 467 for OMB submission.11.7.19_RHC.effective FY2020 and beyond (4.3.20).docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 463	RHC-HCF-Description of Request for Funding Disbursement (FY2021+)	2021 FCC Form 463 - 2.3.21 (clean) v2.docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 466	RHC, Telecommunications Program, Description of Request for Funding (FY2022+)	2020 FCC Form 466_FY 2022+_5.27.21.docx	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

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: State, Local, and Tribal Governments

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)	127,580	127,580
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.