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

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Documents and Forms

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

Information Collection (IC) Details

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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: New

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: ESIX Complaint Submission Form			1230.ESIX 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: 334	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	334	334
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.