Information Collection

Form 2100, Schedule 350 – FM Translator or FM Booster Station License Application

IC 30086 under ICR 202110-3060-007 · OMB 3060-0404.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0404 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Screen Shots for 3060-0404 LMS FM Translator-Booster License (2019).docx	Other-Screen Shots
FCC Form 2100, Schedule 350 LMS License Instructions (FM Booster Translator) (2019).docx	Instruction

IC Title:

Form 2100, Schedule 350 â FM Translator or FM Booster Station License Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screen Shots					Yes	Yes	Fillable Fileable Signable
Instruction					Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

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	Previously Approved
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	18,750	18,750

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.

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