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FCC Form 500
Adjustment to Funding Commitment and Modification to Receipt of Service Confirmation

The FCC Form 500 Adjustment to Funding Commitment and Modification to Receipt of Service Confirmation Form is used by the billed entity applicant who filed a FCC Form 471 on behalf of an eligible school, library, library consortium or consortium of multiple entities, and who received a commitment of funds to inform the fund administrator, the Schools and Libraries Division (SLD) of the Universal Service Administrative Company, that it wishes to reduce the funding commitment amount on the Funding Request Number (FRN) level, or about a modification in the beginning or ending date for services received during the funding year.

The Form 500 must be filed to accomplish the following:

  • To adjust the Funding Year Service Start Date reported on a previously filed Form 486 for this Funding Year
  • To adjust the Contract Expiration Date listed on your Form 471 application for this Funding Year
  • To cancel irrevocably and totally a Funding Request Number (FRN)
  • To reduce irrevocably the amount of a Funding Request Number (FRN)

Downloads

Form 500 Type-in PDF Form 500 "Type In" (for FY 2015 and previous years) December 2016
Form 500 Instructions PDF Form 500 Instructions (for FY 2015 and previous years) December 2016