Bridging the Digital Divide for Low-Income Consumers, Lifeline and Link Up Reform and Modernization, Telecommunications Carriers Eligible for Universal Service Support

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 5629 Lifeline Program Application Form	Form	Modified	Available
Form FCC Form 5631 Lifeline Household Worksheet	Form	Modified	Available
Form FCC Form 5630 Lifeline Annual Recertification Application Form	Form	Modified	Available
Form FCC Form 5630 Businesses or other for-profit	Form	Modified	Repair queued
Form FCC Form 497 Lifeline Worksheet	Form and Instruction	Modified	Available
Form FCC Form 481 Annual Reporting for High-Cost and Low-Income Universal Service Support Recipients	Form	Modified	Available
Form FCC Form 555 Annual Lifeline Eligible Telecommunications Carrier Certification	Form	Modified	Available
Form FCC Form 555 Individuals or Households	Form	Modified	Repair queued
IC 3060-0819 - SS (SCA Survey)_final version 12.2024.docx	Supporting Statement A	Uploaded 2024-12-11	Available
IC 3060-0819 - SS (SCA Survey)_final version 12.2024.docx	Supporting Statement A	Uploaded 2024-12-11	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
218853	Businesses or other for-profit	Form	Modified	Lifeline Program Application Form
218853	Businesses or other for-profit	Form	Modified	Lifeline Household Worksheet
218853	Businesses or other for-profit	Form	Modified	Lifeline Annual Recertification Application Form
218853	Businesses or other for-profit	Form	Modified
218853	Businesses or other for-profit	Other-Lifeline Program Survey Form	Modified
218852	Individuals or Households	Form and Instruction	Modified	Lifeline Worksheet
218852	Individuals or Households	Form	Modified	Annual Reporting for High-Cost and Low-Income Universal Service Support Recipients
218852	Individuals or Households	Form	Modified	Annual Lifeline Eligible Telecommunications Carrier Certification
218852	Individuals or Households	Form	Modified

ICR Details

OMB Control No: 3060-0819	ICR Reference No: 202411-3060-012
Status: Historical Inactive	Previous ICR Reference No: 202405-3060-007
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Bridging the Digital Divide for Low-Income Consumers, Lifeline and Link Up Reform and Modernization, Telecommunications Carriers Eligible for Universal Service Support
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 02/10/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/11/2024
Terms of Clearance: Withdrawn at agency request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2027	36 Months From Approved	08/31/2027
Responses	26,877,412	0	26,877,412
Time Burden (Hours)	6,534,382	0	6,534,382
Cost Burden (Dollars)	937,500	0	937,500

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Abstract: This information collection covers the Commission’s Lifeline program. The Lifeline program is part of the Commission’s universal service efforts and provides qualifying low-income subscribers subsidies to support connectivity services. This collection allows the Commission to collect information necessary for program enrollment, program evaluation, and to conduct oversight of the program’s participating eligible telecommunications carriers.

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Authorizing Statute(s): US Code: 47 USC 303(r), 403, 1302 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 706 Name of Law: Communications Act of 1996, as amended
   US Code: 47 USC 151, 154(i), 155 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 1, 4(i), 5 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 201, 205, 214, 219-220, 254 Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3060-AL48	Final or interim final rulemaking	88 FR 84406	12/05/2023

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 80237	10/02/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 99867	12/11/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Businesses or other for-profit	FCC Form 5631, FCC Form 5629, FCC Form 5630	Lifeline Annual Recertification Application Form ,   Lifeline Household Worksheet ,   Lifeline Program Application Form
Individuals or Households	FCC Form 481, FCC Form 497, FCC Form 555	Annual Lifeline Eligible Telecommunications Carrier Certification ,   Annual Reporting for High-Cost and Low-Income Universal Service Support Recipients ,   Lifeline Worksheet

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Commission is reporting program changes to this information collection to reflect the revision to require providers of services to survivors provide responses to the Safe Connections Act Survey. The total number of respondents increased by +1,300 (from 25,110,068 to 25,111,368 respondents), the total number of annual responses increased by 1,300 (from 26,877,412 to 26,878,712 responses), and the total annual burden hours increased by +217 (from 6,534,382 to 6,534,599 hours). No adjustments are being reported to this information collection.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/11/2024

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