Information Collection

State, Local, or Tribal Government

IC 212990 under ICR 202606-3060-016 · OMB 3060-0806.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FCC 471 Description of Services Requested and Certification Form - Field Descriptions State, Local, or Tribal Government	Form
FCC 471 Description of Services Requested and Certification Form 3060-0806 (Form 471 Field Descriptions).6.23.26.docx	Form

IC Title:

Agency IC Tracking Number:

WCB

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 54.500 47 CFR 54.516(a)-(d) 47 CFR 54.501(a) - (c) 47 CFR 54.502(a) - (d) 47 CFR 54.504(a) - (f)

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 471				Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12,500

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	41,780	41,780
Annual IC Time Burden (Hours)	118,445	118,445
Annual IC Cost Burden (Dollars)	0	0

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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