Multi-Association Group (MAG) Plan Order, Parts 54 and 69 Filing Requirements for Regulation of Interstate Services of Non-Price Cap Incumbent LECs and Interexchange Carriers

Instructions for Completing FCC Form 509
Interstate Common Line Support Mechanism Annual Common Line Actual Cost Data Collection Form

FCC Form 509
OMB Control No. 3060-0972
Estimated Average Burden Hours Per Response: 2.73 Hours

Instructions for Completing
Interstate Common Line Support Mechanism
Annual Common Line Actual Cost Data Collection Form
FCC Form 509
*****
NOTICE: Section 54.903(a)(4) of the Federal Communications Commission's rules requires each rate-of-return incumbent
telecommunications carrier to provide information to USAC, the universal service Administrator, to reconcile the amount
of Interstate Common Line Support that each carrier receives for each of its study areas, based on the carrier’s common
line actual costs in the preceding calendar year. This information must be submitted on December 31st of each year
beginning in 2003, and on that date each year thereafter. This collection of information stems from the Commission's
authority under Section 254 of the Communications Act of 1934, as amended, 47 U.S.C. §254. The data in the form will
be used to calculate and adjust the amount of support, if any, that each reporting carrier is eligible to receive from the
Interstate Common Line Support Mechanism.
We have estimated that each response to this collection of information will take, on average, 2.73 hours. Our estimate
includes the time to read the instructions, look through existing records, gather and maintain the required data, and actually
complete and review the form or response. If you have any comments on this 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 Project (3060-0972), Washington, D.C. 20554. We also will accept your comments via the Internet
if you send them to [email protected]. Please DO NOT SEND COMPLETED DATA COLLECTION FORMS
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 Office of Management and
Budget (OMB) control number. This collection has been assigned an OMB control number of 3060-0972.
The Commission is authorized under the Communications Act of 1934, as amended, to collect the information we
request in this form. We will use the information that you provide to determine Interstate Common Line Support
amounts. If we believe there may be a violation or potential violation of a statute or a Commission regulation, rule, or
order, your form may be referred to the Federal, state, or local agency responsible for investigating, prosecuting,
enforcing, or implementing the statute, rule, regulation, or order. In certain cases, the information in your form may be
disclosed to the Department of Justice, court, or other adjudicative body when (a) the Commission; (b) any employee of
the Commission; or (c) the United States government, is a party to a proceeding before the body or has an interest in the
proceeding. In addition, information provided in or submitted with this form or in response to subsequent inquiries may
also be subject to disclosure consistent with the Communications Act of 1934, FCC regulations, the Freedom of
Information Act, 5 U.S.C. § 552, or other applicable law. Confidential treatment of the filed data may be requested in
the cover letter by following the procedures set forth in Section 0.459 of the Commission’s rules, 47 C.F.R. § 0.459.
If you do not provide the information we request on this form, you are not eligible to receive support under the Interstate
Common Line Support Mechanism, 47.C.F.R. § 54.903.
The foregoing Notice is required by the Paperwork Reduction Act of 1995, P.L. No. 104-13, 44 U.S.C. § 3501, et seq.

Revised November 2004

Instructions for Completing FCC Form 509
Interstate Common Line Support Mechanism Annual Common Line Actual Cost Data Collection Form

Specific Instructions

I.

Introduction and Background.

In the MAG Order (FCC 01-304), the Federal Communications Commission (FCC) modified its
rules to reform the interstate access charge and universal service support system for incumbent local
exchange carriers (LECs) subject to rate-of-return regulation. Pursuant to 47 C.F.R. Sections
54.901-54.904, the FCC established the Interstate Common Line Support (ICLS) Mechanism with
an implementation date of July 1, 2002. The FCC appointed the Universal Service Administrative
Company (USAC) as Administrator of this universal service support mechanism.
II.

The Carrier or the Carrier’s Agent May File This Form.

You may choose to complete FCC Form 509 and submit it to USAC. Alternatively, you may
choose to designate an agent to file FCC Form 509 on your behalf. Please note that, if you choose
to designate an agent to complete and submit FCC Form 509 on your behalf, an authorized officer
or employee of your company must advise USAC of the identity of your agent and certify that the
annual common line actual cost data provided to your authorized agent is accurate to the best of
his/her knowledge. Your authorized agent must: (1) certify that he/she is authorized to submit the
information on behalf of the reporting carrier; (2) certify that the annual common line actual cost
data provided on the form is based on data received from the reporting carrier; (3) certify that the
information on the form is accurate to the best of the agent’s knowledge; and (4) provide copies of
the annual common line actual cost data collection form to the reporting carrier within 15 days of
the filing date. Specific instructions for complying with these steps are set forth below in Section
V. Certifications.
III.

When Must Each Rate-of-Return Incumbent Carrier File FCC Form 509 Annual Common
Line Actual Cost Data Collection Form?

On December 31, 2003, and on that date each year thereafter, each rate-of-return incumbent carrier
must file actual common line cost data for the preceding calendar year. 47 C.F.R. Section
54.903(a)(4).
Filing Due Date for Actual Results of
Operations—Common Line
Information
December 31

Reporting Period for Data

January 1 through December 31 of preceding year

USAC will use this information to adjust each carrier’s monthly per-line ICLS in the following
calendar year. For example, the calendar year 2002 actual common line cost data will be reconciled
with the projected annual common line revenue requirement reported on April 18, 2002.1 Variances
1

The FCC’s Order states that trued-up support amounts in calendar year 2004 will be based on a
prorated share (i.e., 50%) of the 2002 actual costs attributed to the final six months of 2002. MAG
Footnote Continued on next Page…
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Instructions for Completing FCC Form 509
Interstate Common Line Support Mechanism Annual Common Line Actual Cost Data Collection Form

between the projected and actual cost information will be computed. To the extent that any
differences occur between the carrier's projected common line revenue requirement and its actual
results of operations, the differences will be reconciled by making adjustments to the monthly perline ICLS beginning July 1, 2004 through December 31, 2004.
The filing due date of December 31st means that the annual common line actual cost data collection
form must be received by USAC on that date. 47 C.F.R. Section 54.903(a)(4).
IV.

Specific Instructions for Completing This Form.

Block 1 - Contact Information.
Row 1, Carrier Study Area Code: Provide your six-digit numerical code assigned by the National
Exchange Carrier Association (NECA) for the study area in which you serve.
Row 2, Carrier Study Area Name: Provide the standard name that you use to identify your study
area.
Row 3, Service Provider Identification Number: Provide the nine-digit Service Provider
Identification Number (SPIN) that USAC has assigned to you. If you do not know your SPIN,
please contact the HCLI Customer Service Center for assistance. Contact information for the HCLI
Customer Service Center can be found in Section VIII of these instructions.
Row 4, Data Period: Provide the month, day, and year of the start date and end date for the period
for which you have reported information in this form. The annual common line actual cost data
collection form that is due to be filed on December 31, 2003 must report information for the 2002
calendar year, January 1, 2002 through December 31, 2003. For example, you would enter
01/01/2002 - 12/31/2002 for the initial common line actual cost data that you report when you first
complete this form.
Row 5, Submission Date: Provide the month, day, and year of the submission date of the form. The
initial submission of the annual common line actual cost data collection form is due on December
31, 2003, and on that date each year thereafter.
Row 6, Contact Name: Provide the name of the person that USAC should contact to discuss any
questions concerning the information that you submitted in this form.
Row 7, Contact Telephone Number: Provide the telephone number (including area code) of the
person that you identified in Row 6.
Row 8, Contact E-mail Address: Provide the e-mail address of the person that you identified in
Row 6.
Block 2-Actual Annual Common Line Revenue Requirement by Study Area.

Order at ¶167.
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Instructions for Completing FCC Form 509
Interstate Common Line Support Mechanism Annual Common Line Actual Cost Data Collection Form

Row 9, Annual Common Line Costs: Provide your actual annual common line revenue requirement
in dollars, as defined in Part 69 of the FCC’s rules, for the reporting period.
Row 10, Annual SLC Revenues: Provide your actual amount of Subscriber Line Charge (SLC)
revenues in dollars that you collected for the reporting period. 47 C.F.R. Sections 69.104(n),
69.104(o) and 69.104(p).
Row 11, Annual Special Access Surcharge Revenues: Provide your total amount of special access
surcharge revenues in dollars that you collected for the reporting period. 47 C.F.R. Section 69.115.
Row 12, Annual Line Port Costs In Excess Of Basic Analog Service: Provide your total amount of
line port costs in excess of basic analog service revenue in dollars that you collected during the
reporting period. 47 C.F.R. Section 69.130.
Row 13, Annual Long Term Support Revenues: Provide your amount of Long Term Support in
dollars that you collected during the reporting period. 47 C.F.R. Section 54.303(b).
Row 14, Annual Transitional Carrier Common Line Charge Revenues: Provide your total amount of
transitional carrier common line charge revenues in dollars that you collected during the reporting
period. 47 C.F.R. Section 69.105.
V.

Certifications.

You must submit certifications with the signature of an authorized person with the FCC Form 509.
If you are filing FCC Form 509 on your own behalf, you must complete the reporting carrier
certification page. If you are authorizing an agent to file FCC Form 509 on your behalf, on the
other hand, you must complete the top portion of the agent certification page. Once you have
completed the top portion of the agent certification page, your authorized agent must complete the
bottom portion of the agent certification page.
Carriers submitting FCC Form 509 on their own behalf. If you are filing FCC Form 509 on your
own behalf, an authorized officer or employee of your company must complete the reporting carrier
certification page of FCC Form 509. By completing the reporting carrier certification page, the
officer or employee of the reporting carrier is certifying that: (1) he/she is an officer or an employee
of the reporting carrier; (2) his/her responsibilities include ensuring the accuracy of the annual
common line actual cost and revenue data reported on the form; and (3) the information reported on
the form is accurate to the best of his/her knowledge. The certification must be signed by an
authorized officer or employee of the company and must be submitted to USAC along with the
annual common line actual cost and revenue data collection worksheet.
Carriers authorizing an agent to file FCC Form 509 on their behalf. If you are authorizing an agent
to file FCC Form 509 on your behalf, you, as the reporting carrier, must complete the top portion of
the agent certification page of FCC Form 509. By completing the agent authorization section, the
officer or employee of your company is certifying that: (1) the agent identified on the agent
certification is authorized to submit the annual common line actual cost and revenue data to USAC
on your behalf; (2) he/she is an officer or employee of the reporting carrier; (3) his/her
responsibilities include ensuring the accuracy of the annual common line actual cost and revenue
data provided to the authorized agent; and (4) the annual common line actual cost and revenue data
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Instructions for Completing FCC Form 509
Interstate Common Line Support Mechanism Annual Common Line Actual Cost Data Collection Form

provided to the authorized agent is accurate to the best of his/her knowledge. The certification must
be signed by an authorized officer or employee of the company. You will then provide the
certification with the signature of the authorized person to your authorized agent.
Your authorized agent is responsible for completing the bottom portion of the agent certification
page of FCC Form 509. By completing the agent certification section, the authorized agent is
certifying that: (1) he/she is authorized to submit the information on your behalf; (2) the annual
common line actual cost and revenue data provided on the form is based on data received from you
(the reporting carrier); (3) the information provided on the form is accurate to the best of the agent’s
knowledge; and (4) the authorized agent will provide copies of the annual common line actual cost
and revenue data collection form to you within 15 days of the filing date. The certification must be
signed by the authorized agent or an employee of the authorized agent.
Certifications with the signatures of the authorized persons, as well as all of the information
requested on the worksheet of FCC Form 509 for all incumbent rate-of-return carriers, must be
received by USAC in accordance with the filing dates on pages 2 and 3 of these instructions.
Please remember that, if the form is submitted electronically on CD or computer disk in Excel
97 or above, the certifications with the signatures of the authorized persons still must be
received by USAC by the due dates.
VI.

Request for Confidential Treatment of Filed Data.

You may request confidential treatment of some or all of the data filed to qualify for ICLS by
making such a request in your cover letter transmittal of your FCC Form 509 and by complying
with the requirements set forth in 47 C.F.R. Section 0.459.
VII.

Where to File Completed Forms.

You are encouraged to submit the form electronically on CD or computer disk in Excel 97 or
above. The form must be received at the address listed below by the due date. If you are
unable to submit the completed form in electronic format, please submit your paper copies to
the same address.
U.S. Mail, Overnight, or Expedited Mail/Courier Services:
USAC
444Hoes Lane
RRC 4A1060
Piscataway, NJ 08854
(877) 877-4925
VIII.

If You Have Questions.

Please consult the USAC web site, www.universalservice.org/hc, for important information and
updates.
You may submit questions via e-mail to [email protected].
You may telephone USAC’s HCLI Customer Service Center at (877) 877-4925 (toll-free).
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Instructions for Completing FCC Form 509
Interstate Common Line Support Mechanism Annual Common Line Actual Cost Data Collection Form

You may fax your questions to USAC’s HCLI Customer Service Center at (866) 873 (USF)-4695
(toll free).
When submitting any inquiry to USAC’s HCLI Customer Service Center, whether by telephone,
e-mail, or fax, please provide the name of the person submitting the inquiry and the company on
whose behalf the inquiry is submitted, the person’s telephone number, e-mail address, and fax
number, and please describe your inquiry as specifically as possible.

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