Business or other for-profit

Connect America Phase II Auction Waiver Post-Selection Review

Documents and Forms

Document Name Document Type
New York Long-Form - Instructions (May 2018).docx Instruction
FCC Form 5625 Connect America Phase II New York Long-Form Application New York Long-Form - FCC Form 5625 (February 2018).docx Form

Information Collection (IC) Details

IC Title:	Business or other for-profit	Agency IC Tracking Number:	WCB

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 1.2002 47 CFR 54.315

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			New York Long-Form - Instructions (May 2018).docx		Yes	Yes	Fillable Fileable Signable
Form	FCC Form 5625	Connect America Phase II New York Long-Form Application	New York Long-Form - FCC Form 5625 (February 2018).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: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	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.