Business or other for-profit

Universal Service - Rural Health Care Program

OMB: 3060-0804

IC ID: 31049

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0804 can be found here:

2024-07-08 - Revision of a currently approved collection

Documents and Forms

Document Name Document Type
Form FCC Form 460 Business or other for-profit Form and Instruction
FCC Form 460 RHC, HCFP, Description of Eligibility and Registration 2023 Revision FCC Form 460.pdf Form and Instruction
FCC Form 460 RHC, HCFP, Description of Eligibility and Registration 2023 Revision FCC Form 460.pdf Form and Instruction
FCC Form 461 RHC, HFCP, Description of Request for Services 2023 Revision FCC Form 461.pdf Form and Instruction
FCC Form 461 RHC, HFCP, Description of Request for Services 2023 Revision FCC Form 461.pdf Form and Instruction
FCC Form 462 RHC, HCFP, Description of Request for Funding 2023 Revision FCC Form 462.pdf Form and Instruction
FCC Form 462 RHC, HCFP, Description of Request for Funding 2023 Revision FCC Form 462.pdf Form and Instruction
FCC Form 463 RHC, HCFP, Description of Request for Funding Disburseme 2023 Revision FCC Form 463.pdf Form and Instruction
FCC Form 463 RHC, HCFP, Description of Request for Funding Disburseme 2023 Revision FCC Form 463.pdf Form and Instruction
FCC Form 465 RHC, Telecommunications Program, Description of Eligibil 2023 Revision FCC Form 465.pdf Form and Instruction
FCC Form 465 RHC, Telecommunications Program, Description of Eligibil 2023 Revision FCC Form 465.pdf Form and Instruction
FCC Form 466 RHC, Telecommunications Program, Description of Request 2023 Revision FCC Form 466.pdf Form and Instruction
FCC Form 466 RHC, Telecommunications Program, Description of Request 2023 Revision FCC Form 466.pdf Form and Instruction
FCC Form 467 RHC, Telecommunications Program, Connection Certificatio 2023 Revision FCC Form 467.pdf Form and Instruction
FCC Form 467 RHC, Telecommunications Program, Connection Certificatio 2023 Revision FCC Form 467.pdf Form and Instruction
FCC Form 469 RHC, Telecommunications Program, Description of Invoice 2023 Revision FCC Form 469_v2.pdf Form and Instruction
FCC Form 469 RHC, Telecommunications Program, Description of Invoice 2023 Revision FCC Form 469_v2.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Business or other for-profit	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 54.604

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FCC Form 460	RHC, HCFP, Description of Eligibility and Registration	2023 Revision FCC Form 460.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 461	RHC, HFCP, Description of Request for Services	2023 Revision FCC Form 461.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 462	RHC, HCFP, Description of Request for Funding	2023 Revision FCC Form 462.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 463	RHC, HCFP, Description of Request for Funding Disbursement	2023 Revision FCC Form 463.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 465	RHC, Telecommunications Program, Description of Eligibility and Request for Services	2023 Revision FCC Form 465.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 466	RHC, Telecommunications Program, Description of Request for Funding	2023 Revision FCC Form 466.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 467	RHC, Telecommunications Program, Connection Certification Form	2023 Revision FCC Form 467.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FCC Form 469	RHC, Telecommunications Program, Description of Invoice and Request for Disbursement	2023 Revision FCC Form 469_v2.pdf	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,284	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	38,801	4,574	34,227
Annual IC Time Burden (Hours)	147,372	9,552	137,820
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.