Information Collection

Individuals or Households

IC 238054 under ICR 202509-3060-001 · OMB 3060-1267.

Documents and Forms

Document Name Document Type
Form FCC Form 5632 FCC Anti-Harassment Intake Form Individuals or Households Form
FCC Form 5632 FCC Anti-Harassment Intake Form Anti-Harassment Intake Form_Final Version_June 2025.docx Form

Information Collection (IC) Details

View Information Collection (IC)

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

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1604.11(f)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 5632	FCC Anti-Harassment Intake Form	Anti-Harassment Intake Form_Final Version_June 2025.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: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1	-1	2
Annual IC Time Burden (Hours)	4	-5	9
Annual IC Cost Burden (Dollars)	2,025	0	2,025

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.

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