Fcc Form 486 - Schools And Libraries Universal Service Receipt Of Service Confirmation And Children'S Internet Protection Act And Technology Plan Certification Form Page 7
ADVERTISEMENT
1
2
3
4
5
6
7DO NOT STAPLE
Approval by OMB 3060-0853
Entity Number _____________________ Applicant’s Form Identifier _______________________________
Contact Person __________________________________ Phone Number _______________________________
FCC NOTICE FOR INDIVIDUALS REQUIRED BY THE PRIVACY ACT AND THE PAPERWORK REDUCTION ACT
Part 54 of the Commission’s Rules authorizes the FCC to collect the information on this form. Failure to provide all
requested information will delay the processing of the application or result in the application being returned without
action. Information requested by this form will be available for public inspection. Your response is required to obtain the
requested authorization.
The public reporting for this collection of information is estimated to range from 1 to 1.5 hours per response, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the required data, and
completing and reviewing the collection of information. If you have any comments on this burden estimate, or how we
can improve the collection and reduce the burden it causes you, please write to the Federal Communications
Commission, AMD-PERM, Paperwork Reduction Act Project (3060-0853), Washington, DC 20554. We will also accept
your comments regarding the Paperwork Reduction Act aspects of this collection via the Internet if you send them to
PRA@fcc.gov. PLEASE DO NOT SEND YOUR RESPONSE TO THIS FORM TO THIS ADDRESS.
Remember - You are not required to respond to a collection of information sponsored by the Federal government, and
the government may not conduct or sponsor this collection, unless it displays a currently valid OMB control number or if
we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060-0853.
THE FOREGOING NOTICE IS REQUIRED BY THE PRIVACY ACT OF 1974, PUBLIC LAW 93-579, DECEMBER 31,
1974, 5 U.S.C. 552a(e)(3) AND THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW 104-13, OCTOBER 1,
1995, 44 U.S.C. SECTION 3507.
Please submit this form to:
SLD Form 486
PO Box 7026
Lawrence, KS 66044-7026
For express delivery services or U.S. Postal Service, Return Receipt Requested, send this form to:
SLD Forms
ATTN: SLD Form 486
3833 Greenway Dr
Lawrence, KS 66046
888-203-8100
Page 7 of 7
FCC Form 486
December 2013
ADVERTISEMENT
0 votes
Related Articles
Related forms
Fcc Form 479 - Certification By Administrative Authority To Billed Entity Of Compliance With The Children's Internet Protection Act
Legal
Fcc Form 473 - Universal Service For Schools And Libraries Service Provider Annual Certification Form
Legal
Related Categories
Parent category: Business