Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q

Forms and Documents

Document Name	Status
Form FCC Form 499-A Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q Form	Modified
0855_Explanation_of_Non-Substantive_Changes_(0117).doc Justification for No Material/Nonsubstantive Change	2017-01-05
Multiple Collections Non Substantive Change Request (June 2016).doc Justification for No Material/Nonsubstantive Change	2016-06-24
2016 FCC Form 499-Q Instructions REDLINE.pdf Supplementary Document	2016-01-25
2016 FCC Form 499-Q REDLINE.pdf Supplementary Document	2016-01-25
2016 FCC Form 499-A Instructions REDLINE 2PM.pdf Supplementary Document	2016-01-25
2016 FCC Form 499-A REDLINE.pdf Supplementary Document	2016-01-25
0855_Explanation_of_Non-Substantive_Changes_(tapd).docx Justification for No Material/Nonsubstantive Change	2016-01-25
PRA 3060-0855 Explanation of Non-Substantive Changes_2 25 15.doc Justification for No Material/Nonsubstantive Change	2015-02-25
3060-0855 Supporting Statement 10 2 14.docx Supporting Statement A	2014-10-02

IC Document Collections

IC ID	Document Title	Status
188198	Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q Form	Modified

ICR Details

OMB Control No: 3060-0855	ICR Reference No: 201701-3060-004
Status: Historical Active	Previous ICR Reference No: 201606-3060-024
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q
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: 01/23/2017
	Date Received in OIRA: 01/05/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2017	12/31/2017	12/31/2017
Responses	41,650	0	41,650
Time Burden (Hours)	247,375	0	247,375
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. This submission seeks to update (i) FCC Form 499-A; (ii) the accompanying instructions to FCC Form 499-A; (iii) FCC Form 499-Q; and (iv) the accompanying instructions to FCC Form 499-Q. On October 29, 2013, the Commission issued a Public Notice seeking comment on the proposed revisions (DA 16-1269). 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 FCC Form 499-A and Instructions (3060-0855) and FCC Form 499-Q and Instructions (3060-0855). The New Address for the Universal Service Administrative Company (USAC), starting July 12, 2016, will be 700 12th Street, NW, Suite 900, Washington, DC 20005. The above listed forms and instructions will be updated with the new address. This submission is to make a non-substantive change request to an existing information collection pursuant to 44 U.S.C. § 3507. The Commission seeks to modify: (i) the FCC Form 499-A; (ii) the accompanying instructions to the FCC Form 499-A; (iii) the FCC Form 499-Q; and (iv) the accompanying instructions to the FCC Form 499-Q. This submission is to make a non-substantive change request to an existing information collection pursuant to 44 U.S.C. § 3507. The Commission submission seeks to change the FCC Form 499-A Instructions. The Federal Communications Commission (Commission) requires telecommunications carriers and other providers of telecommunications to contribute to the Telecommunications Relay Service Fund. Contribution revenue data, as well as other information, are reported by carriers on FCC Forms 499-A (annual) and 499-Q (quarterly). Accompanying these forms are instructions on how to report revenue. This submission is being made as a revision to an existing information collection to the Office of Management and Budget (OMB) in order to obtain the three year approval for the information collection requirements contained in this collection from OMB. The revision requires the forms in this collection to be filed electronically online (currently, the forms may be filed either electronically or on paper). This submission also removes the third party disclosure burden hours, because there are no longer any respondents subject to a third party disclosure requirement. There are no other substantive revisions to the currently approved information collection, other than updates to the number of entities affected and the burden hours based on the Commission's historical experience with the program. Additionally, because the collection expires in October 2014, the Commission is seeking to extend the currently approved requirements contained in the collection.

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Authorizing Statute(s): US Code: 47 USC 159 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 155 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 157 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 201 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 205 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 214 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 225 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 303(r) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 616 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(j) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(i) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 620 Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 36803	06/30/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 60157	10/06/2014
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
Telecommunications Reporting Worksheets and Related Collections, FCC Forms 499-A and 499-Q	FCC Form 499-A, FCC Form 499-Q , FCC Form 499-A, FCC Form 499-Q	Telecommunications Reporting Worksheet - FCC Form 499-A ,   Telecommunications Reporting Worksheet - FCC Form 499-Q ,   Telecommunications Reporting Worksheet - FCC Form 499-A ,   Telecoommuncations Reporting Worksheet - FCC Form 499-Q

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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	41,650	41,650	0	0	0	0
Annual Time Burden (Hours)	247,375	247,375	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: 01/05/2017

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