FCC Forms 479, 486 and 500 (state, local or tribal entities)

Certification by Administrative Authority to Billed Entity Compliance with the Children's Internet Protection Act Form; Certification of Compliance with the CIPA and Technology Plan Requirements Form;

Documents and Forms

Document Name Document Type
FCC Form 500 Screen Shots.clean.docx Other-FCC Form 500 Screen Shot
FCC Form 500 Screen Shots.clean.docx Other-FCC Form 500 Screen Shot

Information Collection (IC) Details

IC Title:	FCC Forms 479, 486 and 500 (state, local or tribal entities)	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 54.507(d) 47 CFR 54.508(c) 47 CFR 54.513(d) 47 CFR 54.520 47 CFR 54.516

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-FCC Form 500 Screen Shot			FCC Form 500 Screen Shots.clean.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 29,250	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 65 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	36,700	7,450	29,250
Annual IC Time Burden (Hours)	34,138	7,450	26,688
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.