Connect America Challenge Process and Certifications, FCC Form 505

Forms and Documents

Document Name	Status
Form FCC 505 Connect America Challenge Process and Certifications (Not-for-profit institutions) Form	Unchanged
1188_Explanation Non Substantive Changes_061714.doc Justification for No Material/Nonsubstantive Change	2014-06-24
1188_FCC Form 505 Instructions_061714.doc Supplementary Document	2014-06-24
11188_Connect America Fund, Order on Recon WC10-90 FCC 13-97_071513.pdf Supplementary Document	2014-01-31
1188_30 day FRN_013114.pdf Supplementary Document	2014-01-31
1188 60 day FRN_102813.pdf Supplementary Document	2014-01-29
1188 SS_012914 final.doc Supporting Statement A	2014-01-29
NEW_FCC505_OMBCoverLetter_060613.pdf Supplementary Document	2013-06-04

IC Document Collections

IC ID	Document Title	Status
210201	Connect America Challenge Process and Certifications (Not-for-profit institutions) Form	Unchanged
207152	Connect America Challenge Process and Certifications (State, local or tribal Government) Instruction	Unchanged
207150	Connect America Challenge Process and Certifications (Business or other for profit) Instruction	Unchanged

ICR Details

OMB Control No: 3060-1188	ICR Reference No: 201406-3060-019
Status: Historical Active	Previous ICR Reference No: 201310-3060-003
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Connect America Challenge Process and Certifications, FCC Form 505
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/26/2014
	Date Received in OIRA: 06/24/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2017	03/31/2017	03/31/2017
Responses	178	0	178
Time Burden (Hours)	1,793	0	1,793
Cost Burden (Dollars)	0	0	0

---

Abstract: This revised information collection addresses additional requirements to carry out the programs set forth in the USF/ICC Transformation Order. This submission also includes an extension of the certifications related to second round Phase I funding and the requirements contained in FCC Form 505, "Connect America Phase II Challenge Process Form." Additionally, this submission makes non-substantive edits to Form 505 and its instructions.

---

Authorizing Statute(s): US Code: 47 USC 214 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 151 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(i) and 154(j) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 155 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 201(b) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 254 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 1302 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 218-220 Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3060-AJ85	Final or interim final rulemaking	76 FR 73830	11/29/2011

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 64212	10/28/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 5408	01/31/2014
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Connect America Challenge Process and Certifications (Not-for-profit institutions)	FCC 505	Connect America Phase II Challenge Process Form 505
Connect America Challenge Process and Certifications (Business or other for profit)	FCC 505	Connect America Phase II Challenge Process Form 505
Connect America Challenge Process and Certifications (State, local or tribal Government)	FCC 505	Connect America Phase II Challenge Process Form 505

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	178	178	0	0	0	0
Annual Time Burden (Hours)	1,793	1,793	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: In November 2011, the FCC adopted the USF/ICC Transformation Order, et al., WC Docket Nos. 10-90 et al., which reformed the high-cost universal service support mechanisms. As part of the USF/ICC Transformation Order, the Commission adopted several subsequent Orders for implementing the Connect America Phase I and Phase II funding. Then on July 15, 2013, the Commission adopted the Connect America Fund, Order on Reconsideration, WC Docket No. 10-90, FCC 13-97, which modified a reporting requirement contained in an earlier order. This Order on Reconsideration made mandatory the reporting of changes in deployment locations involving census blocks that were not previously identified. This reporting had previously been optional under the original Report and Order.

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/24/2014

---