OMB control number
Reasonable Accommodation Requests, FCC Forms 5626 and 5627
OMB 3060-1246 · FCC.
OMB 3060-1246
This information, completed on FCC Form 5626 and FCC Form 5627 will be used by the OWD to process, track, and maintain the confidentiality of reasonable accommodation requests.
The latest form for Reasonable Accommodation Requests, FCC Forms 5626 and 5627 expires 2029-04-30 and is listed under ICR 202604-3060-003.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form FCC Form 5627 Medical Consent Form | Form |
| Form FCC Form 5626 Reasonable Accommodation Form with Questionnaire | Form |
| 3060-1246_final version_2026.docx | Supporting Statement A |
 Individuals or Households |
Form |
| Federal Government |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202604-3060-003 | Extension without change of a currently approved collection | 2026-04-28 | Approved without change | |
| 202306-3060-003 | Extension without change of a currently approved collection | 2023-06-22 | Approved without change | |
| 202006-3060-010 | Extension without change of a currently approved collection | 2020-07-09 | Approved without change | |
| 201708-3060-012 | New collection (Request for a new OMB Control Number) | 2017-08-18 | Approved without change |
OMB Details
Federal Government
Federal Enterprise Architecture: General Government - Central Fiscal Operations
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form FCC Form 5626 | Reasonable Accommodation Form with Questionnaire | Fillable Fileable Signable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.