Enterprise Service and Public Safety Interference Complaint Intake Form, FCC-5624

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-1230 can be found here:

Documents and Forms

Document Name Document Type
1230.PSIX Complaint Submission Narrative Screenshots_revised(4.30.20).docx Other-Screenshot: PSIX Complaint Sub

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Enterprise Service and Public Safety Interference Complaint Intake Form, FCC-5624	Agency IC Tracking Number:	EB

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screenshot: PSIX Complaint Submission			1230.PSIX Complaint Submission Narrative Screenshots_revised(4.30.20).docx		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 333	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	333	-167	500
Annual IC Time Burden (Hours)	166	-84	250
Annual IC Cost Burden (Dollars)	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.