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

Forms and Documents

Document Name	Status
1230 Supporting Statement_final version_012026.docx Supporting Statement A	2026-01-29

IC Document Collections

IC ID	Document Title	Status
241381	Federal Government Other-Screenshot: ESIX Complaint Submission Form	Modified
226378	State, Local or Tribal Governments Other-Screenshot: ESIX Complaint Submission	Modified
226377	Business or other for-profits Other-Screenshot: PSIX Complaint Submission	Modified

ICR Details

OMB Control No: 3060-1230	ICR Reference No: 202601-3060-013
Status: Active	Previous ICR Reference No: 202303-3060-004
Agency/Subagency: FCC	Agency Tracking No: EB
Title: Enterprise Service and Public Safety Interference Complaint Intake Form, FCC-5624
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Delegated
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/29/2026
	Date Received in OIRA: 01/29/2026
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2029	36 Months From Approved	03/31/2026
Responses	400	0	1,000
Time Burden (Hours)	200	0	500
Cost Burden (Dollars)	0	0	0

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Abstract: The subject information collection provides an efficient mechanism for commercial spectrum licensees, federal spectrum users, and spectrum licensees with a public safety or safety-of-life mission to report incidents of radio interference.

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Authorizing Statute(s): US Code: 47 USC 154(i)-(j), 155, 303(r) Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 53323	11/25/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 53323	11/25/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Business or other for-profits
Federal Government
State, Local or Tribal Governments

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	400	1,000	0	-600	0	0
Annual Time Burden (Hours)	200	500	0	-300	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Regulations

Short Statement: There are no program changes to this information collection. There has been an adjustment/decrease to the total number of respondents/total annual responses from 1,000 to 400 (-600) and a decrease in the total annual burden hours from 500 to 200 (-300). This is based on the most currently available data to the Commission.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/29/2026

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