Information Collection

Businesses or other for-profit

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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC Form 5630 Businesses or other for-profit	Form
Form FCC Form 5630 Lifeline Program Annual Recertification Form Businesses or other for-profit	Form
Form FCC Form 5631 Lifeline Household Worksheet Businesses or other for-profit	Form
Form FCC Form 5629 Lifeline Program Application Form Businesses or other for-profit	Form
Form FCC Form 5630 Lifeline Program Annual Recertification Form Businesses or other for-profit	Form
Form FCC Form 5629 Lifeline Program Application Form Businesses or other for-profit	Form
IC 3060-0819 SCA Survey Form 9.19.24.pdf	Other-Lifeline Program Survey Form
IC 3060-0819 SCA Survey Form 9.19.24.pdf	Other-Lifeline Program Survey Form
FCC Form 5630 Lifeline Program Annual Recertification Form 2026 Lifeline_Recert_Form5630_Rev.01.20.26 not yet approved.pdf	Form
FCC Form 5630 Lifeline Program Annual Recertification Form 2026 Lifeline_Recert_Form5630_Rev.01.20.26 not yet approved.pdf	Form
FCC Form 5631 Lifeline Household Worksheet FCC Form 5631 - Lifeline Household Worksheet (June 2023).pdf	Form
FCC Form 5631 Lifeline Household Worksheet FCC Form 5631 - Lifeline Household Worksheet (June 2023).pdf	Form
FCC Form 5629 Lifeline Program Application Form 2026 Lifeline_App_Form_5629__SCA_Ver._Rev.01.21.26 not yet approved.pdf	Form
FCC Form 5629 Lifeline Program Application Form 2026 Lifeline_App_Form_5629__SCA_Ver._Rev.01.21.26 not yet approved.pdf	Form
FCC Form 5630 Lifeline Program Annual Recertification Form 2026 Lifeline_Recert_Form_5630_Spanish_Rev.01.21.26 not yet approved.pdf	Form
FCC Form 5630 Lifeline Program Annual Recertification Form 2026 Lifeline_Recert_Form_5630_Spanish_Rev.01.21.26 not yet approved.pdf	Form
FCC Form 5629 Lifeline Program Application Form 2026 Lifeline_Application_Form_5629_SCA_Vers_SP_Rev.01.21.26 not yet approved.pdf	Form
FCC Form 5629 Lifeline Program Application Form 2026 Lifeline_Application_Form_5629_SCA_Vers_SP_Rev.01.21.26 not yet approved.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Businesses or other for-profit

Agency IC Tracking Number:

WCB

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 47 CFR 54.1800 47 CFR 54.400, 54.403, 54.405 47 CFR 54.409, 54.410, 54.424

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FCC Form 5630	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 5631	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 5629	Yes	Yes	Fillable Fileable Signable
Other-Lifeline Program Survey Form		Yes	Yes	Fillable Fileable Signable
Form	FCC Form 5630	Yes	Yes	Fillable Fileable Signable
Form	FCC Form 5629	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: FCC/WCB "Lifeline Program"

FR Citation: 86 FR 11526

Number of Respondents: 12,555,684

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	13,439,356	13,439,356
Annual IC Time Burden (Hours)	3,267,300	3,267,300
Annual IC Cost Burden (Dollars)	468,750	468,750

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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