OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Businesses or other for-profit

IC 218853 under ICR 202602-3060-001 · OMB 3060-0819.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Form
Form
Other-Lifeline Program Survey Form
Other-Lifeline Program Survey Form
Form
Form
Form
Form
Form
Form
Form
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Businesses or other for-profit WCB
 
No Modified
 
Voluntary
 
47 CFR 54.1800 47 CFR 54.400, 54.403, 54.405 47 CFR 54.409, 54.410, 54.424

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FCC Form 5630 Lifeline Program Annual Recertification Form 2026 Lifeline_Recert_Form5630_Rev.01.20.26 not yet approved.pdf Yes Yes Fillable Fileable Signable
Form FCC Form 5631 Lifeline Household Worksheet FCC Form 5631 - Lifeline Household Worksheet (June 2023).pdf Yes Yes Fillable Fileable Signable
Form FCC Form 5629 Lifeline Program Application Form 2026 Lifeline_App_Form_5629__SCA_Ver._Rev.01.21.26 not yet approved.pdf Yes Yes Fillable Fileable Signable
Other-Lifeline Program Survey Form IC 3060-0819 SCA Survey Form 9.19.24.pdf Yes Yes Fillable Fileable Signable
Form FCC Form 5630 Lifeline Program Annual Recertification Form 2026 Lifeline_Recert_Form_5630_Spanish_Rev.01.21.26 not yet approved.pdf Yes Yes Fillable Fileable Signable
Form FCC Form 5629 Lifeline Program Application Form 2026 Lifeline_Application_Form_5629_SCA_Vers_SP_Rev.01.21.26 not yet approved.pdf Yes Yes Fillable Fileable Signable

General Government Central Fiscal Operations

FCC/WCB "Lifeline Program"  86 FR 11526

12,555,684 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   80 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 13,439,356 0 0 0 0 13,439,356
Annual IC Time Burden (Hours) 3,267,300 0 0 0 0 3,267,300
Annual IC Cost Burden (Dollars) 468,750 0 0 0 0 468,750

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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