Information Collection

State, Local or Tribal Governments

IC 263883 under ICR 202312-3060-003 · OMB 3060-1323.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-1323 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 472 and F State, Local or Tribal Governments	Form
FCC Form 472 and F Request for Reimbursement 3060-xxxx Cybersecurity Pilot Program (FCC Forms 472-474).12.7.23.docx	Form
FCC Form 472 and F Request for Reimbursement 3060-xxxx Cybersecurity Pilot Program (FCC Forms 472-474).12.7.23.docx	Form
FCC Form 484 Schools and Libraries Cybersecurity Pilot Program Applic 3060-xxxx Cybersecurity Pilot Program Application (FCC Form 484).12.7.23.docx	Form
FCC Form 484 Schools and Libraries Cybersecurity Pilot Program Applic 3060-xxxx Cybersecurity Pilot Program Application (FCC Form 484).12.7.23.docx	Form
FCC Form 488 Post-Commitment Change Request Form 3060-xxxx Cybersecurity Pilot Program (FCC Form 488).12.7.23.docx	Form
FCC Form 488 Post-Commitment Change Request Form 3060-xxxx Cybersecurity Pilot Program (FCC Form 488).12.7.23.docx	Form

IC Title:

State, Local or Tribal Governments

Agency IC Tracking Number:

WCB

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 472 and FCC Form 474	Request for Reimbursement	3060-xxxx Cybersecurity Pilot Program (FCC Forms 472-474).12.7.23.docx	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 484	Schools and Libraries Cybersecurity Pilot Program Application	3060-xxxx Cybersecurity Pilot Program Application (FCC Form 484).12.7.23.docx	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 488	Post-Commitment Change Request Form	3060-xxxx Cybersecurity Pilot Program (FCC Form 488).12.7.23.docx	Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,500

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100,550	100,550
Annual IC Time Burden (Hours)	371,950	371,950
Annual IC Cost Burden (Dollars)	0	0

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.