Individuals or Households

Volunteer Service Agreement Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-1298 can be found here:

Documents and Forms

Document Name Document Type
Form FCC Form A-384 Individuals or Households Form and Instruction
FCC Form A-384 Volunteer Service Agreement A-384-Volunteer Service Agreement new version January 2022 FINAL revised May 18 CLEAN.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Individuals or Households	Agency IC Tracking Number:	OMD-IO

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 47 CFR 2635 47 CFR 19.735-203

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FCC Form A-384	Volunteer Service Agreement	A-384-Volunteer Service Agreement new version January 2022 FINAL revised May 18 CLEAN.docx		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title: OPM/GOVT-1	FR Citation: 77 FR 73694

Number of Respondents: 140	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	140	115	25
Annual IC Time Burden (Hours)	35	29	6
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.