Service Provider and Billed Entity Identification Number and Contact Information Form

Forms and Documents

Document Name	Status
PRA 3060-0824 Explanation of Non-Substantive Changes_10 12 16_2.doc Justification for No Material/Nonsubstantive Change	2016-10-12
Multiple Collections Non Substantive Change Request (June 2016).doc Justification for No Material/Nonsubstantive Change	2016-06-24
0824_Explanation_of_Non-Substantive_Changes (May 2016).doc Justification for No Material/Nonsubstantive Change	2016-05-16
0824_Explanation_of_Non-Substantive_Changes_(03-11-16).doc Justification for No Material/Nonsubstantive Change	2016-03-11
3060-0824 SS (2015 final).docx Supporting Statement A	2015-10-02

IC Document Collections

IC ID	Document Title	Status
44158	Service Provider and Bill Entity Identification Number and Contact Information Form Instruction	Modified

ICR Details

OMB Control No: 3060-0824	ICR Reference No: 201610-3060-004
Status: Historical Active	Previous ICR Reference No: 201606-3060-025
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Service Provider and Billed Entity Identification Number and Contact Information Form
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: 10/13/2016
	Date Received in OIRA: 10/12/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2018	11/30/2018	11/30/2018
Responses	26,000	0	26,000
Time Burden (Hours)	19,500	0	19,500
Cost Burden (Dollars)	0	0	0

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Abstract: This submission is being made for a non-substantive change request to an existing information collection pursuant to 44 U.S.C. § 3507. The Commission seeks to change the FCC Form 498 (3060-0824). The Commission inadvertently omitted the Universal Service Administrative Company's (USAC) new address on FCC Form 498. The updated address is 700 12th Street, NW, Suite 900, Washington, DC 20005.

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Authorizing Statute(s): US Code: 47 USC 151-154 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 254 Name of Law: Communications Act of1934, as amended
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3060-AF85	Final or interim final rulemaking	79 FR 49160	08/19/2014

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 41041	07/14/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 59777	10/02/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Service Provider and Bill Entity Identification Number and Contact Information Form	FCC Form 498, FCC Form 498	Service Provider and Bill Entity Identification Number and General Contact Information Form ,   Service Provider And Billed Entity Identification Number and General Contact Information Form

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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	26,000	26,000	0	0	0	0
Annual Time Burden (Hours)	19,500	19,500	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:

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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

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Common Form ICR:  No

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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: 10/12/2016

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