Information Collection

Telecommunications Relay Services and Sppech-to-Speech Services for Individuals with Hearing and Speech Disabilities

IC 30177 under ICR 202301-3060-003 · OMB 3060-0463.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0463 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Copy of 22 Annual Cost and Demand Filing - Provider Template -Clean.xlsx	Instruction
Copy of 22 Annual Cost and Demand Filing - Provider Template -Clean.xlsx	Instruction
Copy of DRAFT Annual Cost and Demand Filing - State Template 1-3-23.xlsx	Other-Screenshots
Copy of DRAFT Annual Cost and Demand Filing - State Template 1-3-23.xlsx	Other-Screenshots
Annual Cost and Demand Filing Provider Instructions - 1-3-23.docx	Instruction
Annual Cost and Demand Filing Provider Instructions - 1-3-23.docx	Instruction
DRAFT Annual Cost and Demand Filing - State Instructions 1-3-23.docx	Instruction
DRAFT Annual Cost and Demand Filing - State Instructions 1-3-23.docx	Instruction

IC Title:

Telecommunications Relay Services and Sppech-to-Speech Services for Individuals with Hearing and Speech Disabilities

Agency IC Tracking Number:

CGB

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 64.604 47 CFR 64.601 47 CFR 64.606

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	Copy of 22 Annual Cost and Demand Filing - Provider Template -Clean.xlsx	Yes	No	Printable Only
Other-Screenshots	Copy of DRAFT Annual Cost and Demand Filing - State Template 1-3-23.xlsx	Yes	Yes	Fillable Fileable Signable
Instruction	Annual Cost and Demand Filing Provider Instructions - 1-3-23.docx	Yes	No	Printable Only
Instruction	DRAFT Annual Cost and Demand Filing - State Instructions 1-3-23.docx	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: 1,691

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,662	2,662
Annual IC Time Burden (Hours)	4,563	4,563
Annual IC Cost Burden (Dollars)	97,233	97,233

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.