Individuals or Households

Request for Religious Accommodation

Documents and Forms

Document Name Document Type
Form FCC Form 5652 Individuals or Households Form
FCC Form 5652 Request for Religious Accomodation FCC Form 5652_Request for Religious Accommodation_ OWD_January 2024.docx Form
FCC Form 5652 Request for Religious Accomodation FCC Form 5652_Request for Religious Accommodation_ OWD_January 2024_OIRA PB_OWD updates 031124.docx Form

Information Collection (IC) Details

IC Title:	Individuals or Households	Agency IC Tracking Number:	OWD

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 5652	Request for Religious Accomodation	FCC Form 5652_Request for Religious Accommodation_ OWD_January 2024_OIRA PB_OWD updates 031124.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title: FCC/OWD–1, Reasonable Accommodation Requests	FR Citation: 84 FR 3163

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	300	300

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.