Alternative Dispute Resolution Form Requests, FCC Form 5628

OMB 3060-1258

OMB 3060-1258

This information, completed on FCC-5628, will be used by the OWD to process, track, and maintain the confidentiality of Alternative Dispute Resolution Intake Form requests.

The latest form for Alternative Dispute Resolution Form Requests, FCC Form 5628 expires 2021-10-31 and can be found here.


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