Information Collection

Section 73.3700(e), Reimbursement Rules and Form

IC 204896 under ICR 202505-3060-006 · OMB 3060-1178.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 2100, Sch TV Broadcaster Relocation Fund Reimbursement Form Section 73.3700(e), Reimbursement Rules and Form	Form
FCC Form 2100 Schedule 399 Instructions (clean 2019)(final).docx	Instruction
FCC Form 2100, Sch TV Broadcaster Relocation Fund Reimbursement Form FCC Form 399 Oct 19 (Updated).docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 73.3700(e) and 73.3701

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 2100, Schedule 399				Yes	Yes	Fillable Fileable Signable
Instruction					Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	55	-12,022	12,077
Annual IC Time Burden (Hours)	70	-22,997	23,067
Annual IC Cost Burden (Dollars)	22,500	-3,652,500	3,675,000

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.

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