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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.