Low-Power Television and Translator Digital-to-Analog Conversion Program Application Form

Forms and Documents

Document Name	Status
Form DTV-4 Low-Power Television and Translator Digital-to-Analog Conversion Program Application Form Form and Instruction	New
PL_109_171_TitleIII.pdf Supplementary Document	2007-07-25
0660.NEW.LowPowerTV.-1.doc Supporting Statement A	2007-07-25

IC Document Collections

IC ID	Document Title	Status
181149	Low-Power Television and Translator Digital-to-Analog Conversion Program Application Form Form and Instruction	New

ICR Details

OMB Control No: 0660-0022	ICR Reference No: 200707-0660-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOC/NTIA	Agency Tracking No:
Title: Low-Power Television and Translator Digital-to-Analog Conversion Program Application Form
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/17/2007
	Date Received in OIRA: 07/26/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2009	36 Months From Approved
Responses	4,000	0	0
Time Burden (Hours)	2,000	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The application form will be used to implement section 3008 of the The Digital Television Transition and Public Safety Act of 2005 (Act) (see Title III of the Deficit Reduction Act of 2005, Public Law 109-171, 120 Stat. 4, 21 (Feb. 8, 2006)), which directs the National Telecommunications and Information Administration (NTIA) to administer a program through which an eligible low-power television or translator station may receive compensation toward the cost of the purchase of a digital-to-analog conversion device that enables the conversion of the incoming digital signal of its corresponding full-power television station to analog format for transmission on the station’s analog channel.

---

Authorizing Statute(s): PL: Pub.L. 109 - 171 3008 Name of Law: The Digital Television Transition and Public Safety Act of 2005
  

Citations for New Statutory Requirements: PL: Pub.L. 109 - 171 3008 Name of Law: The Digital Television Transition and Public Safety Act of 2005

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 25752	05/07/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 41053	07/26/2007
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Low-Power Television and Translator Digital-to-Analog Conversion Program Application Form	DTV-4	Low-Power Television and Translator Digital-to-Analog Conversion Program Application Form

---

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	4,000	0	4,000	0	0	0
Annual Time Burden (Hours)	2,000	0	2,000	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: The application form will be used to implement section 3008 of the The Digital Television Transition and Public Safety Act of 2005 (Act) (see Title III of the Deficit Reduction Act of 2005, Public Law 109-171, 120 Stat. 4, 21 (Feb. 8, 2006)), which directs the National Telecommunications and Information Administration (NTIA) to administer a program through which an eligible low-power television or translator station may receive compensation toward the cost of the purchase of a digital-to-analog conversion device that enables the conversion of the incoming digital signal of its corresponding full-power television station to analog format for transmission on the station’s analog channel.

---

Annual Cost to Federal Government: $500,000

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

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: 07/26/2007

---