State, Local and Tribal Governments

Enhanced Geo-Targeted Wireless Emergency Alerts

Updated survey 7.15.21 to OMB

State, Local and Tribal Governments

OMB: 3060-1269

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WEA Live Test Survey

OMB Control No. 3060-1269

Estimated time per response: 0.25 hours

[Month approved] 2021



If you have a control group ID number [NNNNN], please enter it here.  Otherwise, leave this field blank.

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Did you receive the WEA test alert?

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Please enter the date and time that you received the alert [MM/DD/YY HH:MM:SS AM/PM].

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What is the make and model of your mobile device (e.g., “Samsung Galaxy S10,” “Apple iPhone X”)? 
If you do not know, leave this field blank.

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What is your mobile device’s operating system?

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Who is your wireless service provider for your mobile device?

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If your wireless service provider is “Other,” please type the name of your provider below.

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Where were you located when the test alert was sent at approximately 2:20 pm EDT on August 11, 2021? 
Please provide a street address or other detailed description.  If you are unsure, please leave these fields blank.

Street Address or Intersection



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City

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State/Territory

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Zip Code

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Other detailed description of location

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Indoors or outdoors?

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Did your mobile device have cellular service on your service provider's network when the alert
was sent at approximately 2:20 pm EDT on August 11, 2021?

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What type of cellular service did your mobile device have?

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Was your device in use when the alert was sent (for example, were you on a call, surfing the web,
using an app or sending a text)?

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Did the alert contain the following message: “THIS IS A TEST of the National Wireless Emergency
Alert System. No action is needed.”?

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Did you receive the alert more than once? If you did not receive the alert, leave this field blank.

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Please provide any optional comments about the WEA test below:



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OMB Notice

We have estimated that your response to this collection of information will take 15 minutes or
.25 hours. Our estimate includes the time to read the instructions, look through existing records,
gather and maintain required data, and actually complete and review the form or response. If you
have any comments on this estimate, or on how we can improve the collection and reduce the
burden it causes you, please write the Federal Communications Commission, Office of Managing
Director, AMD PERM, Washington, DC 20554, Paperwork Reduction Act Project (3060 1269).
We will also accept your PRA comments via the Internet if you send an e-mail to [email protected]

 

Please DO NOT SEND COMPLETED SURVEYS TO THIS ADDRESS. You are not required
to respond to a collection of information sponsored by the Federal government, and the government
may not conduct or sponsor this collection, unless it displays a currently valid OMB control number
and/or we fail to provide you with this notice. This collection has been assigned an OMB control number
of 3060 1269. 

 

THIS NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW
104-13, OCTOBER 1 1995, 44 U.S.C SECTION 3507. 

I have reviewed my responses for accuracy prior to submission.






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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorAustin
File Modified0000-00-00
File Created2021-07-18

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