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Payment Instructions from the Eligible Entity Seeking Reimbursement from the TV Broadcaster Relocation Fund
Payment Instructions from the Eligible Entity Seeking Reimbursement from the TV Broadcaster Relocation Fund.
OMB: 3060-1223
IC ID: 224900
OMB.report
FCC
OMB 3060-1223
ICR 201702-3060-016
IC 224900
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-1223 can be found here:
2022-06-10 - Extension without change of a currently approved collection
2019-03-06 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form FCC Form 1876
Payment Instructions from the Eligible Entity Seeking Reimbursement from the TV Broadcaster Relocation Fund
Form
FCC Form 1876 Relocation Reimbursement Form
Relocation Reimbursement form Dec 13 2016.docx
Form
FCC Form 1876 Relocation Reimbursement Form
PDF Relocation Reimbursement form ver 2 ANNOTATED_Changed REED REVISION.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Payment Instructions from the Eligible Entity Seeking Reimbursement from the TV Broadcaster Relocation Fund
Agency IC Tracking Number:
OMD-FO
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
47 CFR 73.3700(e)(7)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
FCC Form 1876
Relocation Reimbursement Form
Relocation Reimbursement form Dec 13 2016.docx
Yes
Yes
Fillable Fileable Signable
Form
FCC Form 1876
Relocation Reimbursement Form
PDF Relocation Reimbursement form ver 2 ANNOTATED_Changed REED REVISION.pdf
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Fiscal Operations
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
500
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,000
0
0
0
0
1,000
Annual IC Time Burden (Hours)
3,000
0
0
0
0
3,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.