OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Universal Service - Rural Health Care Program

IC 199666 under ICR 202303-3060-005 · OMB 3060-0804.

Documents and Forms
Document Name
Document Type
Other-Post Commitment Form
Other-Post Commitment Form
Other-CMHC Certification Checklist
Other-CMHC Certification Checklist
Other-RHC, Telecom Program Invoice F
Other-RHC, Telecom Program Invoice F
Information Collection (IC) Details

View Information Collection (IC)

Universal Service - Rural Health Care Program WCB
 
No Modified
 
Required to Obtain or Retain Benefits
 
47 CFR 54.600 - 54.633

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Post Commitment Form 2023 Post-Commitment Request Form.docx Yes Yes Fillable Fileable Signable
Other-CMHC Certification Checklist 2023 RHC CMHC-Certification-Checklist.docx Yes Yes Fillable Fileable Signable
Other-RHC, Telecom Program Invoice Form 2023 Telecom Program Invoice.docx Yes Yes Fillable Fileable Signable

Health Health Care Services

 

4,281 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 34,227 0 0 2,998 0 31,229
Annual IC Time Burden (Hours) 137,820 0 0 10,240 0 127,580
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.