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If
you have a control group ID number [NNNNN], please enter
it here. Otherwise, leave this field blank.
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Did
you receive the WEA test alert?
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Please
enter the date and time that you received the alert
[MM/DD/YY HH:MM:SS AM/PM].
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What
is the make and model of your mobile device (e.g.,
“Samsung Galaxy S10,” “Apple iPhone
X”)?
If you do not know, leave this
field blank.
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What
is your mobile device’s operating system?
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Who
is your wireless service provider for your mobile device?
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If
your wireless service provider is “Other,”
please type the name of your provider below.
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Where
were you located when the test alert was sent at
approximately 2:20 pm EDT on August 11, 2021?
Please provide a street address or other detailed
description. If you are unsure, please leave these
fields blank.
Street Address or Intersection
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City
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State/Territory
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Zip
Code
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Other
detailed description of location
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Indoors
or outdoors?
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Did
your mobile device have cellular service on your service
provider's network when the alert
was sent at
approximately 2:20 pm EDT on August 11, 2021?
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What
type of cellular service did your mobile device have?
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Was
your device in use when the alert was sent (for example,
were you on a call, surfing the web,
using an app or
sending a text)?
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Did
the alert contain the following message: “THIS IS A
TEST of the National Wireless Emergency
Alert System.
No action is needed.”?
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Did
you receive the alert more than once? If you did not
receive the alert, leave this field blank.
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Please
provide any optional comments about the WEA test below:
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OMB
Notice
We
have estimated that your response to this collection of
information will take 15 minutes or
.25 hours. Our
estimate includes the time to read the instructions, look
through existing records,
gather and maintain required
data, and actually complete and review the form or response.
If you
have any comments on this estimate, or on how
we can improve the collection and reduce the
burden it
causes you, please write the Federal Communications
Commission, Office of Managing
Director, AMD PERM,
Washington, DC 20554, Paperwork Reduction Act Project (3060
1269).
We will also accept your PRA comments via the
Internet if you send an e-mail to PRA@fcc.gov.
Please
DO NOT SEND COMPLETED SURVEYS TO THIS ADDRESS. 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
and/or we fail to
provide you with this notice. This collection has been
assigned an OMB control number
of 3060 1269.
THIS
NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995,
PUBLIC LAW
104-13, OCTOBER 1 1995, 44 U.S.C SECTION
3507.
☒I
have reviewed my responses for accuracy prior to submission.
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