Download:
pdf |
pdf2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
FCC Form 499-A
DRAFT – NOT YET APPROVED BY OMB 3060-0855
Estimated Average Burden Hours Per Response: 13.5 Hours
2012 Telecommunications Reporting Worksheet Instructions
(FCC Form 499-A)
Table of Contents
Introduction...................................................................................................................................... 2
Filing Requirements and General Instructions................................................................................. 2
A.
Who Must File .................................................................................................................... 2
1.
Universal service exemption for de minimis telecommunications providers......... 4
2.
Exception for government, broadcasters, schools, and libraries............................ 4
3.
Exception for systems integrators and self-providers ............................................ 5
B.
How to File ......................................................................................................................... 5
C.
Filing by Legal Entity ......................................................................................................... 6
D.
Obligation to File Revisions ............................................................................................... 7
E.
Recordkeeping .................................................................................................................... 8
F.
Compliance ......................................................................................................................... 8
G.
Rounding of Numbers and Negative Numbers ................................................................... 9
III.
Specific Instructions ........................................................................................................................ 9
A.
Block 1: Filer Identification Information........................................................................... 9
B.
Block 2: Contact Information .......................................................................................... 10
1.
Block 2-A: Regulatory Contact Information ...................................................... 11
2.
Block 2-B: Agent for Service of Process............................................................ 11
3.
Block 2-C: FCC Registration Information.......................................................... 12
C.
Blocks 3 and 4: Filer Revenue Information ..................................................................... 12
1.
Apportioning Revenues Among Reporting Categories ....................................... 14
2.
Attributing Revenues from Contributing Resellers and from End Users ............ 21
3.
Allocating Revenues between the Jurisdictions................................................... 22
4.
Block 4-B: Total Revenue and Uncollectible Revenue Information .................. 25
5.
Notes for Carriers That Use the USOA ............................................................... 26
D.
Block 5: Additional Revenue Breakouts.......................................................................... 26
E.
Block 6: Certification....................................................................................................... 27
IV.
Calculation of Contributions.......................................................................................................... 29
A.
Contribution Requirements............................................................................................... 29
B.
Contribution Bases............................................................................................................ 31
V.
Additional Information .................................................................................................................. 32
A.
Reminders ......................................................................................................................... 32
B.
Contact Information .......................................................................................................... 32
C.
Paperwork Reduction Act Notice ..................................................................................... 33
Appendix A: How to determine if a filer meets the universal service de minimis standard for 2011
Appendix B: Explanation of categories listed in Line 105
I.
II.
Table 1: Filing Schedule
Table 2: Which Telecommunications Providers Must Contribute for Which Purposes
Table 3: Contribution Bases
File FCC Form 499-A online. http://forms.universalservice.org.
Instructions — Page 1
5
30
31
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
I.
Introduction
The Communications Act of 1934, as amended, requires that the Commission establish mechanisms to
fund universal service (USF), interstate telecommunications relay services (TRS), the administration of
the North American Numbering Plan (NANPA), and the shared costs of local number portability
administration (LNPA). 1 To accomplish these congressionally directed objectives, the Commission
requires telecommunications carriers and certain other providers of telecommunications (including
interconnected Voice-over-Internet-Protocol (VoIP) service providers) to report each year on the
Telecommunications Reporting Worksheet the revenues they receive from offering service. 2 The
administrators of each of these programs use the revenues reported on this Worksheet to calculate and
assess any necessary contributions. The Commission also uses the revenue data reported on this
Worksheet to calculate and assess Interstate Telecommunications Service Provider (ITSP) regulatory
fees. 3
Although some Telecommunications Reporting Worksheet filers may not need to contribute to each of the
support and cost recovery mechanisms, all telecommunications carriers and certain additional
telecommunications providers must file. These instructions explain which filers must contribute to
particular mechanisms, but filers should consult the specific rules that govern contributions for each of the
mechanisms. 4 In general, contributions are calculated based on each filer’s end-user telecommunications
revenue information, as filed in this Worksheet.
By filing this Worksheet, filers may also satisfy their obligations under section 413 of the Act to
designate an agent in the District of Columbia for service of process 5 and their obligations to register with
the Federal Communications Commission. 6
II.
Filing Requirements and General Instructions
A.
Who Must File
With very limited exceptions, all intrastate, interstate, and international providers of telecommunications
in the United States 7 must file this Worksheet. 8 Telecommunications providers that are contributors to
1
47 U.S.C. §§ 151, 225, 251, 254.
2
See 47 C.F.R. §§ 52.17(b), 52.32(b), 54.708, 54.711, 64.604(b)(5)(iii)(B).
3
See 47 U.S.C. § 159(a), (b)(1)(A), (g) (authorizing the Commission to collect annual regulatory fees to recover the
costs of enforcement, policy and rulemaking, user information, and international activities).
4
See 47 C.F.R. §§ 52.17 (numbering administration), 52.32 (local number portability), 54.706 (universal service),
64.604 (interstate TRS).
5
47 U.S.C. § 413; see also 47 C.F.R. § 1.47(h).
6
47 C.F.R. § 64.1195.
7
For this purpose, the United States is defined as the contiguous United States, Alaska, Hawaii, American Samoa,
Baker Island, Guam, Howland Island, Jarvis Island, Johnston Atoll, Kingman Reef, Midway Island, Navassa Island,
the Northern Mariana Islands, Palmyra, Puerto Rico, the U.S. Virgin Islands, and Wake Island.
8
Section 254(d) applies not only to “every telecommunications carrier that provides interstate telecommunications
services” but also to certain “other provider[s] of interstate telecommunications.” 47 U.S.C. § 254(d) (emphasis
added). For more information on these terms, see 47 U.S.C. §§ 153(43), (46); Federal-State Joint Board on
Universal Service, CC Docket No. 96-45, Report and Order, 12 FCC Rcd 8776 (1997) (Universal Service First
Report and Order); Universal Service Contribution Methodology, Federal-State Joint Board on Universal Service,
1998 Biennial Regulatory Review—Streamlined Contributor Reporting Requirements Associated with
Administration of Telecommunications Relay Service, North American Numbering Plan, Local Number Portability,
(continued . . .)
Instructions — Page 2
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
any of the support mechanisms, including USF, TRS, NANPA, or LNPA, must file this Worksheet. The
term “telecommunications” refers to the transmission, between or among points specified by the user, of
information of the user’s choosing, without change in the form or content of the information as sent and
received. 9 For the purpose of filing, the term “interstate telecommunications” includes, but is not limited
to, the following types of services: wireless telephony, including cellular and personal communications
services (PCS); paging and messaging services; dispatch and operator services; mobile radio services; 10
access to interexchange service; special access; wide area telecommunications services (WATS);
subscriber toll-free and 900 services; message telephone services (MTS); private line; telex; telegraph;
video services; satellite services; resale services; Frame Relay services; asynchronous transfer mode
(ATM) services; Multi-Protocol Label Switching (MPLS) services; audio bridging services; 11 and
interconnected VoIP services.
Note that all incumbent and competitive local exchange carriers provide access services and, therefore,
provide interstate telecommunications. No exemptions exist for data or non-voice services.
There is no exception for entities that offer services to a narrow or limited class of users. Thus filers
include:
Entities that provide interstate telecommunications to entities other than themselves for a fee
on a private, contractual basis.
Most telecommunications carriers and all interconnected VoIP providers including those that
qualify for the de minimis exception under the Commission’s universal service rules. 12
Owners of pay telephones, also known as “pay telephone aggregators.”
Marketing agents, i.e., entities that market services on behalf of a telecommunications provider, are not
telecommunications providers and are not required to file this Worksheet. The amounts remitted to or
retained by the marketing agent are treated as expenses of the underlying provider and may not be
deducted from the provider’s revenues. A telecommunications reseller is not a marketing agent and must
file this Worksheet.
All non-interconnected VoIP providers must file this Worksheet in order to register with the Commission
and report their revenues for purposes of calculating TRS contributions.
Some providers may be exempt from contributing to USF, but nevertheless must file this Worksheet
because they are required to contribute to TRS, NANPA, or LNPA. For USF-purposes, these noncontributors must be treated as end users by their underlying carriers and therefore may end up
(. . . continued from previous page)
and Universal Service Support Mechanisms, Telecommunications Services for Individuals with Hearing and Speech
Disabilities, and the Americans with Disabilities Act of 1990, Administration of the North American Numbering
Plan and North American Numbering Plan Cost Recovery Contribution Factor and Fund Size, Number Resource
Optimization, Telephone Number Portability, Truth-In-Billing and Billing Format, IP-Enabled Services, WC Docket
Nos. 06-122, 04-36, CC Docket Nos. 96-45, 98-171, 90-571, 92-237, 99-200, 95-116, 98-170, Report and Order and
Notice of Proposed Rulemaking, 21 FCC Rcd 7518 (2006) (2006 Contribution Methodology Reform Order).
9
47 U.S.C. § 153(43).
10
See Request for Review by Waterway Communication System, LLC and Mobex Network Services, LLC of a
Decision of the Universal Service Administrator, WC Docket No. 06-122, Order, 23 FCC Rcd 12836 (Wireline
Comp. Bur. 2008).
11
See Request for Review by InterCall, Inc. of Decision of Universal Service Administrator, CC Docket No. 96-45,
Order, 23 FCC Rcd 10731, 10737–38, para. 22 (2008) (Intercall Order).
12
See 47 C.F.R. § 54.708.
Instructions — Page 3
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
contributing indirectly as a result of USF pass-through surcharges. If an entity is not required to
contribute to any of these support mechanisms, then it is not required to file this Worksheet. Three types
of non-common-carrier telecommunications providers may, under the circumstances set forth below, not
be required to contribute to USF: (1) de minimis telecommunications providers; (2) government,
broadcasters, schools, and libraries; and (3) systems integrators and self-providers.
1.
Universal service exemption for de minimis telecommunications providers
Telecommunications providers are not required to contribute to the universal service support mechanisms
for a given year if their contribution for that year is less than $10,000. 13 Thus, except as provided below,
providers that offer telecommunications for a fee exclusively on a non-common carrier basis need not file
this Worksheet if their contribution to the universal service support mechanisms would be de minimis
under the universal service rules. Note that entities providing solely private line service may nevertheless
be considered common carriers if they offer their services directly to the public or to such classes of users
as to be effectively available directly to the public. 14
In contrast, although telecommunications carriers providing telecommunications services on a commoncarriage basis that meet the de minimis standard need not contribute to the universal service support
mechanism, they must nevertheless file this Worksheet because they must contribute to other support
mechanisms. Interconnected VoIP providers that meet the de minimis standard must also file this
Worksheet, but they need not file Form 499-Q.
Telecommunications providers that provide telecommunications on a non-common carrier basis and
interconnected VoIP providers should complete the table contained in Appendix A to determine whether
they meet the de minimis standard. To complete this table, providers must first complete Block 4 of the
Worksheet and enter the amounts from Lines 423(d) and 423(e). Providers whose estimated contributions
to universal service support mechanisms would be less than $10,000 are considered de minimis for
universal service contribution purposes and will not be required to contribute directly to universal service
support mechanisms. Use this table to calculate estimated universal service contributions for the period
January 2011 through December 2011.
Providers who do not file this Worksheet because they are de minimis and need not file for any other
purpose should retain the table contained in Appendix A and documentation of their contribution base
revenues for five calendar years after the date each Worksheet is due. 15 Interconnected VoIP providers
who are de minimis must file this Worksheet and retain the table and documentation of their contribution
base revenues for three calendar years after the date each Worksheet is due. 16
2.
Exception for government, broadcasters, schools, and libraries
The following non-common-carrier entities are explicitly exempted from contributing directly to the
universal service support mechanisms and need not file this Worksheet unless they contribute to TRS,
LNP, or NANPA:
13
14
Id.
See 47 U.S.C. § 153(46).
15
See Comprehensive Review of the Universal Service Fund Management, Administration, and Oversight, WC
Docket No. 05-195, Report and Order, 22 FCC Rcd 16372, 16386–87, para. 27 (2007) (USF Comprehensive Review
Order).
16
47 C.F.R. § 54.711(a).
Instructions — Page 4
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Government entities that purchase telecommunications services in bulk on behalf of
themselves, such as state networks for schools and libraries.
Public safety and local governmental entities licensed under Subpart B of Part 90 of the
Commission’s rules or any entity providing interstate telecommunications exclusively to
public safety or government entities who does not offer services to others.
Broadcasters, non-profit schools, non-profit libraries, non-profit colleges, non-profit
universities, and non-profit health care providers.
3.
Exception for systems integrators and self-providers
Systems integrators that derive less than five percent of their systems integration revenues from the resale
of telecommunications are not required to file or contribute directly to universal service. Systems
integrators provide integrated packages of services and products that may include, but are not limited to
computer capabilities, interstate telecommunications, remote data processing services, back-office data
processing, management of customer relationships with underlying carriers and vendors, provision and
maintenance of telecommunications and computer equipment, and help desk functions.
Entities that provide telecommunications only to themselves or to commonly-owned affiliates need not
file.
B.
How to File
This section provides the filing schedule and relevant filing addresses. If a filing date is a holiday (as
defined in section 1.4(e)(1) of the Commission’s rules), Worksheets are due the next business day. See 47
C.F.R. § 1.4(e)(1). There is no fee to file this form.
Table 1: Filing Schedule
What to file
When to file
Where to file
Completed FCC Form
499-A
April 1
http://forms.universalservice.org
February 1
Completed FCC Form
499-Q (universal service May 1
August 1
contributors only)
November 1
http://forms.universalservice.org
Traffic studies relied on
by providers to report
interstate revenues on
FCC Form 499-Q
File one copy with:
[email protected]
AND
File one copy with:
Chief, Industry Analysis and Technology Division
Wireline Competition Bureau
Federal Communications Commission
Room 6-A224
445 12th Street, S.W.
Washington, D.C. 20554
February 1
May 1
August 1
November 1
Filers may also file their FCC Forms 499-A and 499-Q by submitting paper copies to: Form 499 Data
Collection Agent c/o USAC, 2000 L Street N.W., Suite 200, Washington, D.C. 20036.
New telecommunications carriers and other providers of telecommunications or filers with changed
registration information must complete pages 1, 2, 3, and 8 of FCC Form 499-A and submit them within
one week of such change to: Form 499 Data Collection Agent (see address above).
Instructions — Page 5
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Filers that cease providing telecommunications must submit a letter with termination date and information
on its successor, if any, to: Form 499 Data Collection Agent (see address above). These filers must also
update their CORES registration (http://fjallfoss.fcc.gov/coresWeb/publicHome.do).
Telecommunications carriers and interconnected VoIP providers changing information concerning their
designated agent for service of process must complete page 1, Block 2-B, and page 8 of FCC Form 499-A
and submit them within one week of such change to: Chief, Market Dispute Resolution Division,
Enforcement Bureau, Room 4-C342, 445 12th Street, S.W., Washington, D.C. 20554.
Telecommunications carriers and other providers of telecommunications changing any other registration
information must revise the appropriate Blocks, complete page 8 of FCC Form 499-A, and submit them
within one week of such change to: Form 499 Data Collection Agent (see address above).
Please do not send universal service, TRS, NANPA or LNPA contributions with the Worksheet or to any
of the above listed addresses. The appropriate administrators will calculate the amount of contribution
due and send a bill to the billing contact person and billing address identified on Line 208 of the FCC
Form 499-A.
C.
Filing by Legal Entity
Each legal entity providing interstate telecommunications service for a fee or providing interstate
interconnected VoIP service, including each affiliate or subsidiary of an entity, must separately complete
and file a copy of the Worksheet, except as provided below. 17 Entities with distinct articles of
incorporation, articles of formation, or similar legal documents are separate legal entities. Each affiliate
or subsidiary should identify their ultimate controlling parent or entity on Block 1, Line 106.
Entities filing on a consolidated basis must each year certify they meet all of the following conditions: 18
17
A single entity oversees the management of all affiliated systems;
A single entity sends bills to customers identifying it (or a trade name) as the service
provider, rather than identifying the individual legal entities;
All revenues are posted to a single general ledger; 19
If separate revenue and expense accounts exist, they are derived from one consolidated set of
books and the consolidated filing must cover all revenues contained in the consolidated
books;
Customers have a single point of contact;
See also 47 C.F.R. § 64.1195 (outlining the Commission’s registration requirements).
18
See 1998 Biennial Regulatory Review—Streamlined Contributor Reporting Requirements Associated with
Administration of Telecommunications Relay Services, North American Numbering Plan, Local Number Portability,
and Universal Service Support Mechanisms, CC Docket 98-171, Report and Order, 14 FCC Rcd 16602 (1999)
(Consolidated Reporting Order); Federal-State Joint Board on Universal Service; 1998 Biennial Regulatory
Review—Streamlined Contributor Reporting Requirements Associated with Administration of Telecommunications
Relay Service, North American Numbering Plan, Local Number Portability, and Universal Service Support
Mechanisms, Telecommunications Services for Individuals with Hearing and Speech Disabilities, and the Americans
With Disabilities Act of 1990; Administration of the North American Numbering Plan and North American
Numbering Plan Cost Recovery Contribution Factor and Fund Size, Number Resource Optimization, Telephone
Number Portability, Truth-in-Billing and Billing Format, CC Docket Nos. 96-45, 98-171, 90-571, 92-237, 99-200,
95-116, 98-170, Further Notice of Proposed Rulemaking and Report and Order, 17 FCC Rcd 3752 (2002) (First
Further Notice and Report and Order).
19
The FCC Form 499 Filings for the consolidated filer must reflect all revenues in this general ledger.
Instructions — Page 6
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
The consolidated filer acknowledges that process served on it would represent process served
on any or all of the affiliated legal entities;
The consolidated filer agrees to document and resolve all slamming complaints that might be
served on either it or any of the affiliated legal entities; 20
The consolidated filer obtains a separate FCC Registration Number (FRN) from those
assigned to its affiliated legal entities;
The consolidated filer acknowledges that its universal service, TRS, LNP, NANPA, and
regulatory fee obligations will be based on data provided in the consolidated Worksheet
filings, that it bears the responsibility of satisfying those obligations, and that all legal entities
covered by the filing are jointly and severally liable for such obligations; and
The consolidated filer acknowledges that it: (1) was not insolvent on the date it undertook to
make payments on a consolidated basis or on the date of actual payments to universal service,
TRS, LNP, NANPA, and regulatory fees, and did not become insolvent as a result of such
undertaking or payments; (2) was not left with unreasonably small capital as a result of such
undertaking or payments; and (3) was not left unable to pay debts as they matured as a result
of such undertaking or payments. 21
This certification should be filed with the Commission’s Data Collection Agent and must also include:
A list of the legal names of all the legal entities covered by the filing
The FCC Form 499 Filer IDs of all the legal entities covered by the filing
The consolidated filer’s FRN
For wireless carriers, a list of all radio licenses (call signs) issued to each legal entity covered
by the filing
Filers filing on a consolidated basis should be aware that any penalties associated with failure to pay or
underpayment of any of its obligations will be assessed on the total revenue reported on the consolidated
basis, rather than on a separate legal entity basis.
D.
Obligation to File Revisions
Line 612 provides check boxes to show whether the Worksheet is the original April 1 filing for the year, a
registration form for a new filer, a revised filing with updated registration information, or a revised filing
with updated revenue data for the year. Filers must submit a revised Form 499-A if there is any change in
any of the following types of information:
Filer identification in Block 1
Regulatory contact information in Block 2-A
Agent for service of process in Block 2-B
FCC registration information in Block 2-C
20
A Commercial Mobile Radio Service (CMRS) carrier that is not subject to certain slamming regulations is not
required to certify that it will document and resolve all slamming complaints that might be served on either the filer
or any of its affiliated legal entities that also are not subject to the slamming regulations.
21
For purposes of this certification, the term “insolvent” means either unable to pay debts when due or having
liabilities greater than assets. See 11 U.S.C. § 101(32).
Instructions — Page 7
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Filers must also submit revised worksheets if they discover an error in their revenue data. Since
companies generally close their books for financial purposes by the end of March, such filers should base
the April filing on closed books. In filing a revised Worksheet, filers should not include routine out-ofperiod adjustments to revenue data unless such adjustments would affect a reported amount by more than
ten percent. To file revised revenue data, filers must complete Blocks 3, 4, 5, and 6. Filers must submit
any revised Worksheet that would result in decreased contributions by March 31 of the year after the
original filing due date. 22
Filers should not file revised revenue information to reflect mergers, acquisitions, or sales of operating
units. If a filer that submitted a Form 499-A no longer exists, its successor company is responsible for
continuing to make assessed contribution or true-up payments, if any, for the funding period and must
notify the Form 499 Data Collection Agent. If the operations of an entity ceased during the previous
calendar year and are now part of a successor, the successor must include the previous calendar year
revenues of the now-defunct entity with its own Worksheet. The entity that ceased operations may owe,
or its successor may owe, additional universal service contributions or may be due refunds, depending on
how its FCC Form 499-A Worksheet compares to previously filed FCC Form 499-Q Worksheets. Such
entities are not liable for TRS, LNP, or NANPA contributions for the upcoming year. Check the
appropriate boxes on Line 603 and write “Not in business as of filing date” on the explanation line.
E.
Recordkeeping
Filers shall maintain records and documentation to justify information reporting on the Worksheet,
including the methodology used to determine projections and to allocate interstate revenues, for five
years. 23 Additionally, filers must make available all documents and records that pertain to them,
including those of contractors and consultants working on their behalf, to the Commission’s Office of
Inspector General, to the Universal Service Administrative Company (USAC), and to auditors upon
request. 24 Review by the Commission or USAC may cover any existing corporate records, not just those
specifically maintained for these purposes. 25 Entities acquiring carrier operations through consolidation,
merger, etc., must maintain the records of the acquired entity. 26
F.
Compliance
Failure to file the Worksheet, submit traffic studies (if applicable), and pay contributions in a timely
fashion may subject entities to the enforcement provisions of the Communications Act and any other
applicable law. 27 In addition, entities may be billed by the administrators for reasonable costs, including
22
See Federal-State Joint Board on Universal Service; 1998 Biennial Regulatory Review—Streamlined Contributor
Reporting Requirements Associated with Administration of Telecommunications Relay Service, North American
Numbering Plan, Local Number Portability, and Universal Service Support Mechanism; Changes to the Board of
Directors of the National Exchange Carrier Association, Inc., CC Docket Nos. 96-45, 98-171, 97-21, Order, 20
FCC Rcd 1012 (Wireline Comp. Bur. 2004), applications for review pending.
23
See 47 C.F.R. § 54.706(e) (“These records shall include without limitation the following: Financial statements and
supporting documentation; accounting records; historical customer records; general ledgers; and any other relevant
documentation.”).
24
See id.; 47 C.F.R. § 54.711(a).
25
See 47 U.S.C. § 218.
26
See 47 C.F.R. § 42.1.
27
In addition, pursuant to the Debt Collection Improvement Act of 1996, the Commission shall withhold action on
applications or other requests for benefits by delinquent debtors and dismiss those applications or other requests if
the delinquent debt is not paid or satisfactory arrangement for payment is not made. See 47 C.F.R. § 1.1910;
(continued . . .)
Instructions — Page 8
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
interest and administrative costs that are caused by late, inaccurate, or untruthful filing of the Worksheet
or overdue contributions. 28 Inaccurate or untruthful information contained in the Worksheet may lead to
prosecution under the criminal provisions of Title 18 of the United States Code. 29
G.
Rounding of Numbers and Negative Numbers
All information provided in the Worksheet should be neatly printed in ink or typed. Please provide an
original officer signature in ink on Line 606.
Dollar Amounts. — Reported revenues in Blocks 3, 4, and 5 greater than one thousand dollars may be
rounded to the nearest thousand dollars. All dollar amounts must be reported in whole dollars. For
example, $2,271,881.93 could be reported at $2,271,882 or $2,272,000, but not $2272 thousand,
$2,270,000.00, $2,271,881.93, or $2.272 million. Please enter $0 in any line for which the filer had no
revenues for the year.
Percentages. — Percentages reported in Block 3 and Block 4, columns (b) and (c), should be rounded to
the nearest whole percent. For example, if the exact amount of interstate revenues for a line is not known,
but the filer estimates that the ratio of interstate to total revenues was .425, then the figure 43% should be
reported in column (b) and used for calculating the revenue amount reported in column (d).
Negative Numbers. — Filers are directed to provide billed revenues without subtracting any expenses,
allowances for uncollectibles, or settlement payments and without making out-of-period adjustments.
Therefore, do not enter negative numbers on any billed revenue lines on the Worksheet. See instructions
for Lines 421 and 422 regarding uncollectibles.
III.
Specific Instructions
A.
Block 1: Filer Identification Information
Block 1 of the Telecommunications Reporting Worksheet reports identification information.
Line 101. — Enter the “Filer 499 ID” number for the filer, which is assigned by the Commission’s Data
Collection Agent after a company files its first FCC Form 499-A. This code should be entered at the top
of each page on the paper version of the Worksheet, the cover letter, and on any supporting
documentation. Filer 499 ID numbers can be found at:
FCC Form 499 Filer Database (http://fjallfoss.fcc.gov/cgb/form499/499a.cfm)
Telecommunications Provider Locator (http://fcc.gov/wcb/iatd/lec.html)
First time filers should write “New” in the block. New filers will be assigned a Filer 499 ID number after
submitting a completed Worksheet.
Line 102. — Enter the legal name of the filer as it appears on articles of incorporation or articles of
formation and other legal documents. Each legal entity must file a separate Worksheet unless affiliated
entities are filing on a consolidated basis. See section II.C.
(. . . continued from previous page)
Amendment of Parts 0 and 1 of the Commission’s Rules, Implementation of the Debt Collection Improvement Act of
1996 and Adoption of Rules Governing Applications or Requests for Benefits by Delinquent Debtors, MD Docket
No. 02-339, 19 FCC Rcd 640 (2004).
28
See 47 C.F.R. § 54.713 (universal service); 47 C.F.R. § 64.604(c)(5)(iii)(B) (TRS); see also 47 C.F.R. § 52.17(b)
(NANPA); 47 C.F.R. § 52.32(c) (LNPA).
29
See 47 C.F.R. § 54.711.
Instructions — Page 9
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Line 103. — Enter the Internal Revenue Service (IRS) employer identification number (EIN) for the filer,
which should be the same EIN that the company uses to file any federal taxes, if the filer offers services
subject to such taxes. The EIN is the entity’s taxpayer identification number (TIN) or an individual’s
social security number (SSN). Consolidated filers must provide the EIN of the holding company.
Line 104. — Enter the principal name under which the filer conducts telecommunications activities,
typically the name that appears on customer bills or the name used when service representatives answer
customer inquiries.
Line 105. — Mark the boxes that describe the telecommunications activity or activities of the filer. If
more than one is appropriate, label the activities in order of importance to the filer’s business. Enter a 1
in the box that is the most important activity, a 2 in the next most important, etc., but select no more than
5 categories. An explanation of the categories appears in Appendix B.
Line 106. — Enter a common identifier for all affiliated filers, typically the name of the filer’s holding
company or controlling entity, if any. All reporting affiliates or commonly owned entities should have
the identical name appearing on Line 106.1 and identical IRS EIN on Line 106.2.
Line 107. — Enter the FCC Registration Number (FRN) of the filer. The FRN is a ten-digit number that
includes a check-digit and is used to identify an entity within all Commission Licensing/Filing systems
and the Commission’s Revenue Accounting Management Information System (RAMIS). The number is
assigned by the Commission Registration System (CORES). For more information, see
https://fjallfoss.fcc.gov/coresWeb/publicHome.do.
Line 108. — Enter the name of the management company if the filer is managed by an entity other than
itself. If the filer and one or more telecommunications provider(s) are commonly managed, then each
should show the same management company on Line 108. Filers need not be affiliated to have a common
management company. The management company would typically be the point of contact for the
administrators of the support mechanisms.
Line 109. — Enter the complete mailing address of the corporate headquarters of the filer.
Line 110. — Enter a business address for the filer that could be used either for customer inquiries or that
parties could use to contact the filer in order to resolve complaints. Check the box if this address is the
same as the mailing address of the corporate headquarters on Line 109.
Line 111. — Enter a telephone number that can be used to resolve customer complaints, for customer
service, or for billing inquiries, such as a customer toll-free number.
Line 112. — Enter all names that the filer used in the past three years for providing telecommunications.
Enter all names by which the filer would be known to customers, government bodies, creditors, the press,
etc. Consolidated filers should provide all names used by all telecommunications affiliated covered by
the filing. The list must include the filer’s billing agents if those partiers, rather than the filer, are
identified on customer bills, and should also include names of predecessor companies that would have
contributed to universal service, TRS, NANP, or LNP or filed a Telecommunications Reporting
Worksheet in the prior year. In such cases, include the prior Filer 499 ID as part of the name, as this
information will be used by the administrators in instances where other information indicates that a nonfiler might exist and also to ensure that entities are not billed improperly for predecessor companies that
no longer exist. Use an additional sheet if this space is not sufficient.
B.
Block 2: Contact Information
Block 2 of the Telecommunications Reporting Worksheet reports contact information for regulatory and
billing purposes.
Instructions — Page 10
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
1.
Block 2-A: Regulatory Contact Information
Line 201. — Enter the Filer 499 ID from Line 101.
Line 202. — Enter the legal name of the filer from Line 102.
Lines 203–206. — Enter the name, telephone number, and fax number of the person who filled out the
FCC Form 499. An email address is also required and will not be publicly released. This person should
be able to provide clarifications or additional information and, if necessary, serve as the first point of
contact if either the Commission or an administrator should choose to verify or audit information
provided in the Worksheet.
Line 207. — Enter the contact person name, office name, and mailing address of a corporate office to
which future Worksheets should be sent. An email address is also required and will not be publicly
released. The next Worksheet will be mailed to this address unless other arrangements are made. Failure
to receive a Worksheet from an administrator or the FCC does not relieve the filer from its obligation to
file in a timely fashion.
Line 208. — Enter a billing contact person name and address for administrators to send billing
information for contributions. An email address is also required and will not be publicly released.
Information on establishing electronic fund transfer and bills for universal service, TRS, NANPA, or
LNPA contributions will be sent to this address unless other arrangements are made via written request.
An FCC ITSP regulatory fee bill, if due, will be sent to the email address specified on Line 208.1.
2.
Block 2-B: Agent for Service of Process
Section 413 of the Act requires each carrier “to designate in writing an agent in the District of Columbia”
upon whom all notices, process, orders, and decisions made by the Commission may be served on behalf
of that carrier in any proceeding pending before the Commission. 30 Section 1.47(h) of the Commission’s
rules extends that requirement to interconnected and non-interconnected VoIP providers. 31
Lines 209–218. — Carriers, interconnected VoIP providers, and non-interconnected VoIP providers must
enter the name, business address, telephone or voicemail number, fax number, and, if available, email
address for their designated D.C. Agent. Carriers, interconnected VoIP providers, and non-interconnected
VoIP providers must designate a single agent for service of process in D.C. for all Commission business.
Service of any notice, process, orders, decisions, and requirements of the Commission may be made upon
the filer by leaving a copy thereof with this designated agent during normal business hours at the agent’s
office or other usual place of residence.
In addition to this information, the filer may elect to provide a local or alternate agent for service of
process located outside D.C. Filers other than carriers, interconnected VoIP providers, or noninterconnected VoIP providers need only report one agent for service of process, whether located inside
D.C. or otherwise. Although the FCC Form 499-A permits carriers, interconnected VoIP providers, and
non-interconnected VoIP providers to designate a preferred alternate or local agents for service of
process, each designated agent for a carrier, interconnected VoIP provider, or non-interconnected VoIP
provider must accept service for all purposes relating to Commission business. A carrier, interconnected
VoIP provider, or non-interconnected VoIP provider may not limit a designated agent’s ability to accept
service on behalf of the carrier, interconnected VoIP provider, or non-interconnected VoIP provider by
subject matter, jurisdiction, affiliate or any other grounds. The Commission may assume that the local or
alternate agent is the filer’s preferred destination for all service of process.
30
47 U.S.C. § 413.
31
47 C.F.R. § 1.47(h).
Instructions — Page 11
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
New carriers, interconnected VoIP providers, and non-interconnected VoIP providers must identify an
agent for service of process within 30 days of providing service and all carriers, interconnected VoIP
providers, and non-interconnected VoIP providers must notify the FCC within one week if the contact
information changes for their D.C. Agent.
3.
Block 2-C: FCC Registration Information
New telecommunications carriers and other telecommunications providers must register with the
Commission when they begin to provide service. Carriers and other telecommunications providers must
update registration information within one week of a material change. Registration information includes
information reported in Blocks 1 and 2 of the Telecommunications Reporting Worksheet.
Lines 219–226. — As explained above, virtually all carriers filing the FCC Form 499 are considered to be
interstate carriers. They, along with interconnected and non-interconnected VoIP providers, must provide
the names and business addresses of their Chief Executive Officer, Chairman, and President.
Please refer to the following list for instructions for different types of providers:
If the filer does not have one or more of these officers, then names should be supplied for the
three most senior-level officers of the filer
If the same person occupies more than one position, then names should be supplied for the
three most senior-level officers of the filer
If the filer is a sole proprietorship, list only one name
If the filer is a partnership, list the managing partner on Line 221
If the filer is owned by two partners, list the second partner on Line 223
If there are three or more partners, list information for the managing partner and the two other
partners with the greatest financial interest in the partnership
For purposes of this filing, an officer is an occupant of a position listed in the article of incorporation,
articles of formation, or other similar legal document.
Line 227. — Check those jurisdictions where the filer provided telecommunications service or
interconnected VoIP service in the past 15 months, and any additional jurisdictions in which the filer
expects to provide such services in the next 12 months. Identify jurisdictions where customers physically
obtain service, and for switched services, identify jurisdictions where customers can originate calls. For
services where the called party pays, however, also identify jurisdictions where calls terminate. 32 For
example, an operator service provider that handled inmate calls originating in New Jersey and terminating
collect in New Jersey, New York, and Pennsylvania, would identify those three states as jurisdictions
served.
Line 228. — Enter the year and month that the filer first provided telecommunications or interconnected
or non-interconnected VoIP service. If not yet providing either service, then the filer should indicate the
year and month it expects to begin operations. If operations began prior to January 1, 1999, the filer may
so indicate by using the check box rather than entering the specific date.
C.
Blocks 3 and 4: Filer Revenue Information
Blocks 3 and 4 of the Telecommunications Reporting Worksheet report revenue information for calendar
year 2011.
32
Both parties to a collect call are “consumers.” 47 C.F.R § 64.708; see also 47 C.F.R § 64.710(b)(1).
Instructions — Page 12
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Line 301 and Line 401. — Enter the Filer 499 ID from Line 101.
Lines 302 and Line 402. — Enter the legal name of the filer from Line 102.
Lines 303–314 and Lines 403–418. — Report gross billed revenues as directed. For most filers,
completing Lines 303–314 and 403–418 is a three-step process. First, the filer must assign its gross billed
revenues to reporting categories, which includes allocating revenues from bundled services between their
telecommunications and non-telecommunications components. Second, the filer must attribute
telecommunications revenues derived from sales to contributing resellers or from sales to end users.
Third, the filer must apportion its telecommunications revenues between the intrastate, interstate, and
international jurisdictions.
Gross billed revenues include revenues from all sources, including non-regulated telecommunications
offerings, information services, and other non-telecommunications services. Gross revenues consist of
total revenues billed to customers during the filing period with no allowances for uncollectibles,
settlements, or out-of-period adjustments. Gross revenues include:
Account set-up
Connection
Service restoration
Termination
Revenues derived from the activation and provision of interstate, international, and intrastate
telecommunications and non-telecommunications services
Collection overages and unclaimed refunds for telecommunications and telecommunications
services when not subject to escheats
Surcharges on telecommunications services or interconnected VoIP services that are billed to
the customer and either retained by the filer or remitted to a non-government third party
under contract
Any other non-recurring charges
These charges should be reported on the same line that the filer reports any associated recurring revenue.
Deposits are not revenues. Gross revenues do not include amounts that cannot be billed to customers and
may be distinct from booked revenues. Gross billed revenues also do not include revenues (imputed or
otherwise) for services provided to the filer itself or from one wholly owned affiliate to another unless:
(1) the filer is required to record such revenues for some other federal or state regulatory purpose; or
(2) the filer is providing service to an affiliate for resale and the affiliate is not a direct universal service
contributor. Lastly, gross revenues should exclude taxes and surcharges that are not recorded on the
company books as revenues, but are instead remitted to government bodies. Any charge on a customer
bill represented to recover or collect contributions to federal and state universal service support
mechanisms must be shown separately on Line 403.
National Exchange Carrier Association (NECA) pool companies should report the actual gross billed
revenues (CABS Revenues) reported to the NECA pool and not settlement revenues received from the
pool. Entities making consolidated filings must include in their FCC Form 499 Filings all revenue on the
consolidated books of account. Note that deposits are not revenues and that credits should not be
deducted from billed revenues when the credit is issued. Instead, filers should include redeemed credits
with uncollectible amounts reported on Line 421 and Line 422.
Instructions — Page 13
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
When two filers merge, the successor company should report total revenues for the reporting period for
all predecessor operations, unless the filers maintain separate corporate identities and both continue to
operate. In that special case, each filer should continue to report its revenues separately. 33 Where an
entity obtains, by any means whatsoever, the telecommunications operations or customer base of a filer,
the acquiring company must report all telecommunications revenues associated with such operations or
customer base including revenues billed in the calendar year prior to the date of acquisition.
Note on International Services. — For international services, gross billed revenues consist of gross
revenues billed by U.S. telecommunications providers with no allowances for settlement or settlementlike payments. International settlement and settlement-like receipts for foreign-billed service should not
be included in U.S. telecommunications revenues. Note that if the filer receives the foreign-bound traffic
in the United States, then it is providing ordinary international service from the United States to a foreign
point; receipts from the originating carrier should be reported as revenue on Line 414. Filers may report
international revenues in section 43.61 reports that are net of credits at the time the credits are issued.
Note on Gross Earned Revenues Reporting. — Filers that maintain records in accordance with generally
accepted accounting principles and that record revenues when earned instead of when billed, may use
earned revenues to represent billed revenues as long as they do so consistently from reporting period to
reporting period. Filers using earned revenues to represent billed revenues need not impute earned
revenue for redeemed credits if no earned revenue is recorded when credits are redeemed. To the extent
that earned revenues are net of any uncollectible amounts, these uncollectible amounts must not be
included on Line 421 or Line 422.
1.
Apportioning Revenues Among Reporting Categories
If revenue category breakout cannot be determined directly from corporate books of account or subsidiary
records, filers may provide on the Worksheet a good-faith estimate of the breakout. Good-faith estimates
should be based on information that is current for the filing period. Filers should maintain documentation
for good-faith estimates and entities may not simply report all revenues on one of the “other revenue”
lines.
Filers with any revenues for Lines 303–314 and 403–420 may not omit the dollar amounts from column
(a), even if all of the revenues are for interstate or international services.
Filers may report revenues from contributing resellers (i.e., universal service contributors) on Lines 303
through 314 and must report all other revenues on Lines 403 through 418. 34 In many cases, the line-item
categories are duplicated in the two sections. Carriers that are required to use the Uniform System of
Accounts (USOA) prescribed in Part 32 of the Commission’s rules should base their responses on their
USOA account data and supplemental records, dividing revenues into those received from universal
service contributors and those received from end users and other non-contributors. 35 All filers should
report revenues based on the following descriptions.
i.
Fixed local service revenue categories
Fixed local services connect a specific point to one or more other points. These services can be provided
using either wireline, fixed wireless, or interconnected VoIP technologies and can be used for local
exchange service, private communications, or access to toll services.
33
See also section II.C.
34
See section III.C.2.
35
See section III.C.5.
Instructions — Page 14
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Line 303 and Line 404. — Monthly service, local calling including message and local toll charges,
connection charges, vertical features, and other local exchange services should include the basic local
service revenues except for local private line revenues, special access revenues, and revenues from
providing mobile or cellular services. These lines should include charges for optional extended area
service, dialing features, local directory assistance, added exchange services such as automatic number
identification (ANI) or teleconferencing, LNP surcharges, connection charges, charges for connecting
with mobile service and local exchange revenue settlements. Filers should break out these revenues as
follows:
Line 303.1. — Revenues for services provided to carriers as unbundled network elements (UNEs)
Line 303.2. — Revenues for services provided to carriers under tariffs or arrangements other than
unbundled network elements (for example, resale). Line 303.2 should also include Presubscribed
Interexchange Carrier Charge (PICC) charges levied on carriers.
Line 404.1. — Local service portion of revenues from local exchange service provided using noninterconnected VoIP for plans that include interstate calling as part of the flat monthly fee.
Line 404.2. — Toll portion of revenues from local exchange service provided using noninterconnected VoIP for plans that include interstate calling as part of the flat monthly fee (Note:
if the revenue from the toll portion of such service is attributed to an affiliate, that affiliate must
report such revenues on Line 404.2, not on Line 414).
Line 404.3. — Revenues from non-interconnected VoIP local exchange services plans that do not
include interstate calling.
Line 404.4. — Revenues from Local service provided via interconnected VoIP service offered in
conjunction with a broadband connection.
Line 404.5. — Revenues from Local service provided via interconnected VoIP service offered
independent of the broadband connection. 36
Line 404 should not include subscriber line charges levied under a tariff filed by the filer or placed on
customer bills as a pass-through of underlying carrier subscriber line charges. Filers should instead report
such revenues on line 405. Note that federal subscriber line charges typically represent the interstate
portion of fixed local exchange service; these amounts are separate from toll revenues and correspond to
the revenues received by incumbent telephone companies to recover part of the cost of networks that
allow customers to originate and terminate interstate calls. Filers without subscriber line charge revenue
must identify the interstate portion of fixed local exchange service revenues in column (d) of the
appropriate line 404.1–404.5. Line 404.1–404.5 should, however, include revenues from federally
tariffed LNP surcharges, which should be identified as interstate revenues. Interconnected VoIP
providers not reporting based on the safe harbor must make a similar allocation as well as determine the
appropriate portion of revenues to allocate to interstate and international toll service.
Line 304. — Line 304 should include per–minute charges for originating or terminating calls. This line
also would include revenues to the local exchange carrier for messages between a cellular customer and
another station within the mobile service area, in addition to any other gross charges to other carriers for
the origination or termination of toll or non-toll traffic. Do not deduct or net payments to carriers for
origination or termination of traffic on their networks.
36
Bundled broadband and interconnection offerings include those offered directly by the filer and those offered by
the filer through an affiliate.
Instructions — Page 15
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Line 304.1 — Revenues for originating and terminating minutes provided under state or federal
access tariffs.
Line 304.2 — Revenues for originating and terminating minutes provided as unbundled network
elements or other contract arrangements.
Line 304 includes direct trunk transport, port charges, mileage charges and rearrangement charges that are
normally treated as access charge revenues. 37 Do not include international settlement or settlement-like
receipts or transiting fees from international toll services.
Line 405. — Line 405 should include charges to end users specified in access tariffs, such as tariffed
subscriber line charges and PICC charges levied by a local exchange carrier on customers that are not
presubscribed to an interexchange carrier (i.e., a no-PIC customer). Line 405 should not include charges
to end users for special access services (which are reported on Line 406). Telecommunications providers
that do not have subscriber line charge or PICC tariffs on file with the Commission or with a state utility
commission or who are not reselling such tariffed charges, should report $0 on Line 405.
Line 305 and Line 406. — Local private line and special access service should include revenues from
providing local services that involve dedicated circuits, private switching arrangements, digital subscriber
lines, and/or predefined transmission paths. Line 406 should include revenues from special access lines
resold to end users unless the service is bundled with and charged as part of a toll service, in which case
the revenues should be reported on the appropriate toll service line. Report on Lines 305 and 406
revenues from offering dedicated capacity between specified points even if the service is provided over
local area switched, multi-protocol label switching (MPLS), asynchronous transfer mode (ATM), or
frame relay networks. Amounts reported on Line 305 should be divided between:
Line 305.1 — Revenues for service provided to contributing resellers for resale as
telecommunications.
Line 305.2 — Revenues for service provided to contributing resellers for resale as interconnected
VoIP.
Amounts reported on Line 406 include revenues from the transmission component of wireline broadband
Internet access service to the extent described below, as well as other revenue from private line and
special access service. 38 Specifically, Line 406 includes all revenue from broadband service (including
the transmission component of wireline broadband Internet access service) provided on a common carrier
basis. Revenues for the provision of wireline broadband Internet access transmission on a non-common37
47 C.F.R. Part 69.
38
Wireline broadband Internet access service is a service that uses wireline facilities of the telephone network to
provide subscribers with Internet access capabilities. It can be provided over facilities such as copper loops, hybrid
copper-fiber loops, fiber-to-the-curb, fiber-to-the-premises, or any other type of wireline facilities, and can use
circuit-switched, packet-based, or any other technology. Wireline broadband Internet access service inextricably
intertwines information-processing capabilities with data transmission such that the consumer always uses them as a
unitary service. Wireline broadband Internet access service should be carefully distinguished from other wireline
broadband services such as ATM, frame relay, gigabit Ethernet service, and other stand-alone high-capacity special
access services that end users have traditionally used for basic transmission purposes. These services lack the key
characteristics of wireline broadband Internet access service—they do not inextricably intertwine transmission with
information-processing capabilities. Because these services typically are used for basic transmission purposes, they
are telecommunications services and must be reported on Line 406. See Appropriate Framework for Broadband
Access to the Internet Over Wireline Facilities; Universal Service Obligations of Broadband Providers; Review of
Regulatory Requirements for Incumbent LEC Broadband Telecommunications Services; Computer III Further
Remand Proceedings, CC Docket Nos. 02–33, 01–337, 95–20, 98–10, Report and Order, 20 FCC Rcd 14853,
14860, para. 9 (2005) (Wireline Broadband Internet Access Services Order) (subsequent history omitted).
Instructions — Page 16
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
carrier basis should be reported on Line 418. All other revenues from local private line service and
special access service billed to end users must be reported on Line 406.
Line 306 and Line 407. — Line 306 should include revenues received from carriers as payphone
compensation for originating toll calls. Line 407 should include revenues received from customers paid
directly to the payphone service provider, including all coin-in-the-box revenues. Do not deduct
commission payments to premises’ owners.
Line 307 and Line 408. — Local telecommunications service revenues that reasonably would not be
included with one of the other fixed local service revenue categories. Line 307 should include charges for
physical collocation of equipment pursuant to 47 U.S.C. § 251(c)(6). Report any revenues from offering
switched capacity on local area data networks such as ATM or frame relay networks.
Line 308. — Universal service support revenues should include all amounts that filers receive as universal
service support from either states or the federal government. Line 308 should include as revenues
Lifeline Assistance reimbursement for the waived portion of subscriber line or presubscribed
interexchange carrier charges from the Low Income or High Cost universal service support mechanisms.
Line 308 should include amounts received as cash as well as amounts received as credit against
contribution obligations. Line 308 should not include any amounts charged to customers to recover
universal service or similar contributions. Line 308 should not include charges or credits for subsidized
services provided to schools, libraries, and rural health care providers. Such charges are properly reported
as end user revenue.
ii.
Mobile service
Mobile services are wireless communications between mobile wireless equipment, such as cellular
phones and other points.
Line 309, Line 409, and Line 410. — Data reported on these lines should contain mobile service revenues
other than toll charges to mobile service customers. Charges associated with customer premises
equipment should not be included on these lines.
Line 309. — Revenues for all mobile service provided to contributing resellers, including
revenues received from another carrier for roaming service provided to customers of that carrier.
Line 409. — Revenues for mobile service provided to end users, including monthly charges,
activation fees, service restoration, and service order processing charges, etc. End–user prepaid
wireless service revenues attributable to activation and daily or monthly access charges should be
reported on Line 409.
Line 410. — Revenues for mobile service provided to end users, including message charges, any
roaming charges assessed on customers for calls placed out of customers’ home areas and local
directory assistance charges. End–user prepaid wireless service revenues attributable to airtime
should be reported on Line 410.
Itemized toll charges to mobile service customers should be included in the Lines 413 or 414, as
appropriate.
Roaming charges for service provided by foreign carriers operating in foreign points are not U.S.
telecommunications revenues and therefore should be reported on Line 418.
iii.
Toll service revenue categories
Toll services are telecommunications services, wireline, wireless, or interconnected VoIP services, that
enable customers to communicate outside of local exchange calling areas. Toll service revenues include
intrastate, interstate, and international long distance services.
Instructions — Page 17
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Line 411. — Revenues from prepaid calling cards provided either to customers, distributors or to retail
establishments. Prepaid card includes prepaid service where the customer utilizes the service provider’s
switching platform and a personal identification number (PIN) for purposes of verification and billing,
even if the customer does not receive a physical card. 39 Gross billed revenues should represent the
amounts actually paid by end user customers and not the amounts paid by distributors or retailers, and
should not be reduced or adjusted for discounts provided to distributors or retail establishments. All
prepaid card revenues are classified as end–user revenues. For purposes of completing this Worksheet,
prepaid card revenues should be recognized when end–user customers purchase the cards. The
international portion of revenue, however, should be reported consistently with the filer’s 43.61
international traffic data reports.
Line 310 and Line 413. — Operator and toll calls with alternative billing arrangements should include all
calling card or credit card calls, person-to-person calls, and calls with alternative billing arrangements
such as third–number billing, collect calls, and country-direct type calls that either originate or terminate
in a U.S. point. These lines should include all charges from toll or long distance directory assistance.
Lines 310 and 413 should include revenues from all calls placed from all coin and coinless, public and
semi-public, accommodation and prison telephones, except that calls that are paid for via prepaid calling
cards should be included on Line 411 and calls paid for by coins deposited in the phone should be
included on Line 407.
Line 311, Line 412, and Line 414. — Filers should report ordinary long distance revenues on these lines,
including revenues from most toll calls placed for a fee and flat monthly charges billed to customers, such
as account maintenance charges, PICC pass-through charges, and monthly minimums. This category
should include ordinary message telephone service (MTS), WATS, subscriber toll-free, 900, “WATSlike,” and similar switched services. Ordinary long distance includes separately stated toll revenue from
wireline, wireless, and interconnected VoIP services. 40 Ordinary long distance revenues should be
reported as follows:
Line 311. — Ordinary long distance provided to contributing resellers.
Line 414.1. — Ordinary long distance provided to end users using non-interconnected VoIP
technologies, including toll service that employs Internet Protocol but that is not provided on an
interconnected VoIP basis. 41
Line 414.2. — Separately billed revenue for ordinary long distance provided to end users using
interconnected VoIP.
39
See AT&T Corp. Petition for Declaratory Ruling Regarding Enhanced Prepaid Calling Card Services; Regulation
of Prepaid Calling Card Services, WC Docket Nos. 03-133, 05-68, Order and Notice of Proposed Rulemaking, 20
FCC Rcd 4826, 4827–4827, para. 3 (2005); see also Universal Service Contribution Methodology; Request for
Review of Decision of the Universal Service Administrator by Network Enhanced Telecom, LLP, WC Docket No.
06-122, USAC Audit CR2008CP001, Order, 25 FCC Rcd 14533, 14538–39, paras. 12–13 (Wireline Comp. Bur.
2010).
40
See 2006 Contribution Methodology Reform Order, 21 FCC Rcd at 7534, para. 29. Toll services are
telecommunications services that enable customers to communicate outside of their local exchange calling areas,
which for wireless providers means outside the customer’s plan–defined home calling area. See Separately Stated
Toll Order, 23 FCC Rcd at 1414, para. 5. The term “home calling area” is used generally by wireless carriers to
denote the plan–defined area in which a subscriber may make calls and incur no additional charges beyond the planspecific per month charge, assuming the subscriber does not exceed the plan allotted minutes. Id. at 1419 n.28.
41
See Petition for Declaratory Ruling that AT&T’s Phone-to-Phone IP Telephony Services are Exempt from Access
Charges, WC Docket No. 02-361, Order, 19 FCC Rcd 7457 (2004) (AT&T IP-in-the-Middle Order).
Instructions — Page 18
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Note that the revenues for the toll portion of flat rated non-interconnected VoIP local service should be
reported on Line 404.2, regardless of whether this portion of revenue is reported by a local exchange
carrier or by its toll affiliate. Note also that the revenue for the toll portion of flat rated interconnected
VoIP local service should be reported on Line 404.4 or Line 404.5, as appropriate.
International calls that traverse the United States but both originate and terminate in foreign points are
excluded from the universal service contribution base. Such end-user revenues should be segregated from
other toll revenues by showing them on Line 412. Such reseller revenues should be reported on Line 311.
Telecommunications providers should not report international settlement revenues from traditional
settlement transiting traffic on the Worksheet.
For carriers providing international telecommunications services, the total revenues identified as
international on Line 419(e) should match the total U.S. billed revenues that will be reported each year
pursuant to 47 C.F.R. § 43.61 except in very limited circumstances, such as receipts from foreign carriers
for calls that are reoriginated and reported as U.S. billed traffic. For example, if a filer receives payment
from a foreign carrier for traffic that the filer receives outside of the United States, brings into the United
States, and then refiles and carries the traffic to a foreign point, the filer would not include those
settlement-like payments as revenues on Line 414 of the FCC Form 499-A even though they might be
reported as revenues on the filer’s 43.61 international traffic data report. Instead, those amounts would be
reported on Line 418. Revenue from circuits within the United States that connect a customer to an
international circuit should be reported as interstate. Revenue from circuits that connect foreign points
should be reported on Line 418.
Line 312 and Line 415. — Long distance private line service should include revenues from dedicated
circuits, private switching arrangements, and/or predefined transmission paths, extending beyond the
basic service area. Line 312 and Line 415 should include frame relay and similar services where the
customer is provided a dedicated amount of capacity between points in different basic service areas. This
category should include revenues from the resale of special access services if they are included as part of
a toll private line service. For international private line services, U.S. providers must report on Line 415
revenues from the U.S. portion of the circuit to the theoretical midpoint of the circuit regardless of
whether such revenues were billed to the customer by the reporting carrier or by a partner carrier in a
foreign point.
Line 313 and Line 416. — Satellite services should contain revenues from providing space segment
service and earth station link-up capacity used for providing telecommunications or telecommunications
services via satellite. Revenues derived from the lease of bare transponder capacity should not be
included on Lines 313 and 416.
Line 314 and Line 417. — All other long distance services should include all other revenues from
providing long distance communications services. Line 314 and Line 417 should include toll
teleconferencing. 42 Line 314 and Line 417 should include switched data, frame relay and similar services
where the customer is provided a toll network service rather than dedicated capacity between two points.
Line 314 should also include revenues from all non-interconnected VoIP services sold to contributing
resellers that are not otherwise includable in Lines 303 to 313.
iv.
Other revenue categories
Line 403. — Itemized charges levied by the filer in order to recover contributions to state and federal
universal service support mechanisms should be classified as end-user billed revenues and should be
reported on Line 403. Any charge identified on a bill as recovering contributions to universal service
42
Audio bridging service providers should report all audio bridging revenues as telecommunications revenues. See
Intercall Order, 23 FCC Rcd at 10734, 10739, para. 8, 25–26.
Instructions — Page 19
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
support mechanisms must be shown on Line 403 and should be identified as either interstate or
international revenues, as appropriate. Filers should report intrastate revenues on line 403 only to the
extent that actual payments to state universal service programs were recovered by pass-through charges
itemized on customer bills.
Line 418. — Other revenues that should not be reported in the contribution bases. Line 418 should
include all non-telecommunications service revenues on the filer’s books, as well as some revenues that
are derived from telecommunications-related functions, but that should not be included in the universal
service or other fund contribution bases. For example, information services offering a capability for
generating, acquiring, storing, transforming, processing, retrieving, utilizing, or making available
information via telecommunications are not included in the universal service or other fund contribution
bases. Information services do not include any use of any such capability for the management, control, or
operation of a telecommunications system or the management of a telecommunications service. For
example, voice mail, call moderation, and call transcription services are information services. Revenues
allocated to these services should be reported on Line 418. Line 418 should also include revenues from
published directory services, billing and collection services, inside wiring, inside wiring maintenance
insurance, pole attachments, open video systems (OVS), cable leased access, cable service, and direct
broadcast satellite (DBS) service. Line 418 should include revenues from the sale, lease, installation,
maintenance, or insurance of customer premises equipment (CPE) and from the sale or lease of
transmission facilities, such as dark fiber or bare transponder capacity, that are not provided as part of a
telecommunications service or as a UNE. Line 418 should include late payment charges and charges
imposed by the filer for customer checks returned for non-payment. Line 418 should include revenues
from telecommunications provided in a foreign country where the traffic does not transit the United States
or where the provider is offering service as a foreign carrier, i.e., a carrier licensed in that country.
Revenue reported on Line 418 should be divided into four categories:
Line 418.1. —Revenues from other non-telecommunications goods or services that are bundled
with U.S. wireline or wireless circuit switched exchange access services.
Line 418.2. — Revenues from other non-telecommunications goods or services that are bundled
with U.S. interconnected VoIP service.
Line 418.3. — All revenues properly reported on line 418 other than those in Lines 418.1, 418.2,
and 418.4, including wireline broadband Internet access service that is not reportable on Line 406
and all non-common carrier wireline broadband Internet access service and cable modem service
(to the extent that cable modem service is being provided by an entity already filing an FCC Form
499-A).
Line 418.4. — Revenues from non-interconnected VoIP services sold to end users that are not
otherwise includable on Lines 403 to 417. Non-interconnected VoIP service is a service that
(i) enables real-time voice communications that originate from or terminate to the user’s location
using Internet protocol or any successor protocol and (ii) requires Internet Protocol compatible
customer premises equipment, but (iii) is not an interconnected VoIP service. Only include
revenues from October 1, 2011 through December 31, 2011; report revenues from January 1,
2011 through September 30, 2011 on Line 418.3.
Reporting Revenues from Bundled Offerings. — Allocation of revenues between either wireline or
interconnected VoIP telecommunications and bundled non-telecommunications, such as information
services and consumer premises equipment (CPE), are governed by the Commission’s bundling rules.
The Commission adopted two safe harbor methods for allocating revenue when telecommunications
services and CPE/enhanced services are offered as a bundled package. The first option is to report
revenues from bundled telecommunications and CPE/enhanced service offerings based on the unbundled
service offering prices, with no discount from the bundled offering being allocated to telecommunications
services. Alternatively, filers may elect to treat all bundled revenues as telecommunications service
Instructions — Page 20
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
revenues for purposes of determining their universal service obligations. Filers may choose to use
allocation methods other than the two described above. Filers should realize, however, that any other
allocation method may not be considered reasonable and will be evaluated on a case-by-case basis in an
audit or enforcement context. Prepaid calling card providers may avail themselves of the bundled service
safe harbors for separating revenue between telecommunications and information services. 43
2.
Attributing Revenues from Contributing Resellers and from End Users
Filers must report revenues using two broad categories: (1) revenues from contributing resellers and
(2) revenues from all other sources. Taken together, these revenues should include all revenues billed to
customers and should include all revenues on the filers’ books of account. Although some categories of
revenues are automatically attributed—for example, all per-minute switched access charges are treated as
carrier’s carrier revenues reported in Block 3 and all universal service pass-through charges are treated as
end-user revenues reported in Block 4—most categories of revenues require the filer to determine
whether the customer purchasing the telecommunications is a contributing reseller or instead an end user.
For the purposes of this Worksheet, “Revenues from services provided for resale by other contributors to
federal universal service support mechanisms” are revenues from services provided by underlying carriers
to other entities that currently are contributors to universal service support mechanisms and that are resold
in the form of telecommunications. Such revenues are referred to herein as “carrier’s carrier revenues” or
“revenues from resellers.” An underlying carrier also may include as carrier’s carrier revenues any
international switched service revenues received from another U.S. reselling carrier where that reselling
carrier is using the underlying carrier’s service to re-file the foreign-billed traffic of a foreign telephone
operator. In this case, the reselling carrier must certify to the underlying carrier that it is using the resold
international switched service to handle traffic that both originates and terminates in foreign points. In
some instances, reselling carriers are themselves selling the underlying service to another reseller. In
these instances, an underlying carrier also may include as carrier’s carrier revenue any revenues received
from service provided to resellers who certify to the underlying carrier that: (a) all of the reseller’s
customers are themselves FCC Form 499-A worksheet filers; and (b) all of the reseller’s customers are
direct contributors to universal service support mechanisms. Revenues from all other sources consist
primarily of revenues from services provided to end users, referred to here as “end-user revenues.” This
latter category includes foreign and non-telecommunications revenues.
For the purpose of completing Block 3, a “reseller” is a telecommunications carrier or
telecommunications provider that: (1) incorporates purchased telecommunications services into its own
telecommunications offerings; and (2) can reasonably be expected to contribute to federal universal
service support mechanisms based on revenues from such offerings when provided to end users.
Each filer should have documented procedures to ensure that it reports as “revenues from resellers” only
revenues from entities that reasonably would be expected to contribute to support universal service. The
procedures should include, but not be limited to, maintaining the following information on resellers: Filer
499 ID; legal name; address; name of a contact person; phone number of the contact person; and, as
described below, the annual certification by the reseller and evidence of the filer’s use of the FCC’s
website to validate the contributor status of the reseller. Filers shall provide this information to the
Commission or the Administrator upon request.
43
Policy and Rules Concerning the Interstate, Interexchange Marketplace; Implementation of Section 254(g) of the
Communications Act of 1934, as Amended; 1998 Biennial Regulatory Review—Review of Customer Premises
Equipment and Enhanced Services Unbundling Rules in the Interexchange, Exchange Access and Local Exchange
Markets, CC Docket Nos. 96-61, 98-183, Report and Order, 16 FCC Rcd 7418, 7446–48, paras. 47–54 (2001); see
also Regulation of Prepaid Calling Card Services, WC Docket No. 05-68, Declaratory Ruling, Report and Order, 21
FCC Rcd 7290, 7298, para. 22 (2006).
Instructions — Page 21
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Each year, the filer must obtain a signed statement from the reseller containing the following language:
I certify under penalty of perjury that the company is purchasing service for resale in the form of
U.S. telecommunications or interconnected Voice over Internet Protocol service. I also certify
under penalty of perjury that either the company contributes directly to the federal universal
support mechanisms, or that each entity to which the company provides resold
telecommunications is itself an FCC Form 499 worksheet filer and a direct contributor to the
federal universal service support mechanisms.
In addition, to facilitate verification of a reseller’s certification, current contributors to universal service
are identified http://fjallfoss.fcc.gov/cgb/form499/499a.cfm. Filers may use the website to verify the
continuing validity of a reseller’s certification, and may presume that any reseller identified as a
contributor in this website in the month prior to an FCC Form 499-Q filing will be a contributor for the
coming quarter, and that it was a contributor for all prior quarters during that calendar year. Filers that do
not comply with the above procedures will be responsible for any additional universal service assessments
that result if its customers must be reclassified as end users.
Note: For the purposes of filling out this Worksheet—and for calculating contributions to the universal
service support mechanisms—certain telecommunications carriers and other providers of
telecommunications may be exempt from contribution to the universal service support mechanisms.
These exempt entities, including “international only” and “intrastate only” providers and providers that
meet the de minimis universal service threshold, should not be treated as resellers for the purpose of
reporting revenues in Block 3. That is, filers that are underlying carriers should report revenues derived
from the provision of telecommunications to exempt carriers and providers (including services provided
to entities that are de minimis for universal service purposes) on Lines 403–417 of Block 4 of the
Telecommunications Reporting Worksheet, as appropriate. Underlying carriers must contribute to the
universal service support mechanisms on the basis of such revenues. In Block 5, Line 511, however,
filers may elect to report the amounts of such revenues (i.e., those revenues from exempt entities that are
reported as end-user revenues) so that these revenues may be excluded for purposes of calculating
contributions to TRS, LNPA, and NANPA.
3.
Allocating Revenues between the Jurisdictions
Columns (b), (c), (d), and (e) are provided to identify the part of gross revenues that arise from interstate
and international services for each entry on Lines 303 through 314 and Lines 403 through 417. Intrastate
telecommunications means communications or transmission between points within the same State,
Territory, or possession of the United States, or the District of Columbia. Interstate and international
telecommunications means communications or transmission between a point in one state, territory,
possession of the United States or the District of Columbia and a point outside that state, territory,
possession of the United States or the District of Columbia. Revenues from services offered under
interstate tariffs, such as revenues from federal subscriber line charges and from federally tariffed LNP
surcharges, should be identified as interstate revenues. This includes amounts incorporated in or bundled
with other local service charges.
For example, if a prepaid calling card provider collects a fixed amount of revenue per minute of traffic,
and 65 percent of minutes are interstate, then interstate revenues would include 65 percent of the perminute revenues. Similarly, if a local exchange carrier bills local measured service charges for calls that
originate in one state and terminate in another, these billings should be classified as interstate even though
the charges are covered by a state tariff and the revenues are included in a local service account. If over
ten percent of the traffic carried over a private or WATS line is interstate, then the revenues and costs
Instructions — Page 22
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
generated by the entire line are classified as interstate. 44 In general, flat-rated unbundled network access
elements should be classified according to the regulatory agency that has primary jurisdiction over the
contracts.
Amounts billed to customers to recover federal universal service contribution obligations should be
attributed as either interstate or international revenues, as appropriate, but may not be reported as
intrastate revenues. Filers should report intrastate revenues on Line 403 only to the extent that actual
payments to state universal service programs were recovered by pass-through charges itemized on
customer bills.
Note: Where possible, filers should report their amount of total revenues that are intrastate, interstate, and
international by using information from their books of account and other internal data reporting systems.
Where a filer can determine the precise amount of revenues that it has billed for interstate and
international services, it should enter those amounts in columns (d) and (e), respectively.
If the allocation of revenues cannot be determined directly from corporate books of account or subsidiary
records, filers may provide on the Worksheet good-faith estimates of these figures. In such cases, the filer
should enter the good-faith estimates of the percentage of interstate and the percentage of international
revenues in columns (b) and (c), respectively. A reporting entity may not submit a good-faith estimate
lower than one percent unless the correct figure should be $0. Good-faith estimates must be based on
information that is current for the filing period. Information supporting good-faith estimates must be
made available to either the FCC or to the administrators upon request. Using the good-faith estimate,
calculate the amount of interstate revenues as the amount in column (a) times the percentage in column
(b), and calculate the amount of international revenues as the amount in column (a) times the percentage
in column (c). Enter zero dollars in columns (d) and (e) if and only if there were no interstate or
international revenues for the line for the reporting period.
The FCC provides the following safe harbor percentages of interstate revenues associated with Line 309,
Line 409, and Line 410: 45
37.1% of cellular and broadband PCS telecommunications revenues
12.0% of paging revenues
1.0% of analog SMR dispatch revenues
These safe harbor percentages may not be applied to universal service pass-through charges, fixed local
service revenues, or toll-service charges. All filers must report the actual amount of interstate and
international revenues for these services. For example, toll charges for itemized calls appearing on
mobile telephone customer bills should be reported as intrastate, interstate or international based on the
origination and termination points of the calls.
44
See 47 C.F.R. § 36.154(a).
45
See 2006 Contribution Methodology Reform Order, 21 FCC Rcd at 7532–33, 7545–46, paras. 25–27, 53–55;
Federal-State Joint Board on Universal Service; 1998 Biennial Regulatory Review—Streamlined Contributor
Reporting Requirements Associated with Administration of Telecommunications Relay Service, North American
Numbering Plan, Local Number Portability, and Universal Service Support Mechanisms; Telecommunications
Services for Individuals with Hearing and Speech Disabilities, and the Americans With Disabilities Act of 1990,
Administration of the North American Numbering Plan and North American Numbering Plan Cost Recovery
Contribution Factor and Fund Size, Number Resource Optimization, Telephone Number Portability,
Truth-in-Billing and Billing Format, CC Docket Nos. 96-45, 98-171, 90-571, 92-237, 99-200, 95-116, 98-170,
Report and Order and Second Further Notice of Proposed Rulemaking, 17 FCC Rcd 24952 (2002) (Contribution
Methodology Order); see also Federal-State Joint Board on Universal Service, CC Docket No. 96-45,
Memorandum Opinion and Order and Further Notice of Proposed Rulemaking, 13 FCC Rcd 21252, 21258–60
(1998).
Instructions — Page 23
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
The FCC provides the following safe harbor percentage of interstate revenues associated with Line 303.2,
Line 314, Line 404.4, Line 404.5, Line 414.2, and Line 418.4:
64.9% of interconnected VoIP and non-interconnected VoIP telecommunications revenues
These safe harbor percentages may not be applied to universal service pass-through charges or other fixed
local service revenues.
Wireless telecommunications providers and interconnected and non-interconnected VoIP providers that
choose to avail themselves of these safe harbor percentages for interstate revenues may assume that the
FCC will not find it necessary to review or question the data underlying their reported percentages. All
affiliated wireless telecommunications providers and interconnected and non-interconnected VoIP
providers must make a single election, each quarter, whether to report actual revenues or to use the
current safe harbor within the same safe harbor category. 46 So, for example, if in a calendar quarter a
wireless telecommunications provider reports actual interstate revenues for its cellular and broadband
PCS telecommunications services, all of its affiliated legal entities must also report actual interstate
telecommunications revenues for cellular and broadband PCS offerings. The same wireless
telecommunications provider and all affiliates, however, could use the safe harbor for paging services.
Annual revenues reported on the FCC Form 499-A should reflect the filer’s reporting of revenues in each
quarter on FCC Form 499-Q. For example, if a filer projected revenue based on a safe harbor for the first
two quarters and based on traffic studies for the final two quarters, the amounts reported in the FCC Form
499-A for the first two quarters would be based on actual billings for those quarters and the relevant safe
harbors, and the amounts reported for the final two quarters would be based on actual billings for those
quarters and the traffic studies for those quarters.
Many carriers and other providers of telecommunications now offer packages that bundle fixed local
exchange service with interstate toll service for a single price. Revenues for the whole bundle, except for
tariffed subscriber line and PICC charges, should be reported on Line 404, as described more fully above.
The portion of revenues associated with interstate and international toll services must be identified in
columns (d) and (e), respectively. 47 Filers should make a good-faith estimate of the amounts of intrastate,
interstate, and international revenues from bundled local/toll service if they cannot otherwise determine
these amounts from corporate records, and must make their methodology available to the Commission or
the Administrator, upon request.
Wireless telecommunications providers and interconnected and non-interconnected VoIP providers may
rely on traffic studies if they are unable to determine their actual interstate and international revenues. 48
In developing their traffic studies, such providers may rely on statistical sampling to estimate the
proportion of minutes that are interstate and international. Any revenues associated with charges on
customer bills that are identified as interstate or international must effectively be accounted for (e.g.,
46
See Federal-State Joint Board on Universal Service, CC Docket No. 96-45, Order and Order on Reconsideration,
18 FCC Rcd 1421 (2003). Note: Wireless telecommunications providers are “affiliated” for purposes of making the
single election whether to report actual interstate telecommunications revenues or use the applicable interim wireless
safe harbor if one entity (1) directly or indirectly controls or has the power to control another, (2) is directly or
indirectly controlled by another, (3) is directly or indirectly controlled by a third party or parties that also controls or
has the power to control another, or (4) has an “identity of interest” with another contributor. See also 47 C.F.R.
§ 1.2110(c)(5).
47
See Universal Service Contribution Methodology, Petition for Declaratory Ruling of CTIA – The Wireless
Association on Universal Service Contribution Obligations, Petition for Declaratory Ruling of Cingular Wireless,
LLC, WC Docket No. 06-122, Declaratory Order, 23 FCC Rcd 1411, 1414, para. 5 (2008) (defining “toll service”)
(Separately Stated Toll Order).
48
See 2006 Contribution Methodology Reform Order, 21 FCC Rcd at 7534–36, 7547, paras. 29–33, 57.
Instructions — Page 24
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
through proper weighting in a traffic study) as 100 percent interstate or international when reporting
revenues. 49 Sampling techniques must be designed to produce a margin of error of no more than one
percent with a confidence level of 95%. If the sampling technique does not employ a completely random
sample (e.g., if stratified samples are used), then the respondent must document the sampling technique
and explain why it does not result in a biased sample. Traffic studies should include, at a minimum:
(1) an explanation of the sampling and estimation methods employed and (2) an explanation as to why the
study results in an unbiased estimate with the accuracy specified above. Mobile telecommunications
providers and interconnected VoIP providers should retain all data underlying their traffic studies as well
as all documentation necessary to facilitate an audit of the study data and be prepared to make this data
and documentation available to the Commission upon request. In addition, filers that rely on traffic
studies must submit those studies to the Commission and USAC for review (see section II.B for filing
instructions).
Filers report total uncollectible revenue/bad debt expenses on Lines 421 and 422. Filers that maintain
separate detail of uncollectibles by type of business should rely on those records in dividing uncollectible
expense between carrier’s carrier, contribution base and other revenues, and for dividing uncollectibles
associated with contribution base revenues between intrastate, interstate and international categories.
Filers that do not have such detail should make such assignments in proportion to reported gross
revenues.
4.
Block 4-B: Total Revenue and Uncollectible Revenue Information
The Administrator relies on the detail line information on the Worksheet to arrive at the totals shown in
Block 4-B. The Administrator will attempt to resolve conflicts between any sums that differ from the
information entered into the totals on Block 4-B.
Line 419. — Gross billed revenues from all sources should equal the sum of revenues by type of service
reported on Lines 303 through 314 and Lines 403 through 418.
Line 420. — Universal service contribution base revenues should equal the subtotal of Lines 403 through
411 and Lines 413 through 417 for each column. The totals on this line represent gross end-user revenues
for the purpose of determining contributions to universal service support mechanisms. See section III.D
(Line 511 instructions).
Line 421. — Show the uncollectible revenue/bad debt expense associated with gross billed revenues
amounts reported on Line 419. In addition, for those using billed revenues, this line may include
redeemed credits. Reported uncollectible amounts should be the amount reported as bad debt expense in
the filer’s income statement for the year. Note that it will cover uncollectibles associated with all revenue
on the filer’s books (Line 419), including uncollectible carrier’s carrier revenues, end-user
telecommunications revenues, and revenues reported on Line 418. The filer’s uncollectible revenues/bad
debt expense should be calculated in accordance with Generally Accepted Accounting Principles. Thus,
uncollectibles should represent the portion of gross billed revenues that the filer reasonably expects will
not be collected. Note that uncollectibles may not include any amounts associated with unbillable
revenues. 50 Filers that operate on a cash basis should report $0 on this line. Filers that used earned
revenue to represent billed revenues should not report as uncollectible any billings that are not included in
earned revenues.
49
See Separately Stated Toll Order, 23 FCC Rcd at 1418, para. 15. In developing traffic studies, toll service traffic
must be identified and treated in a manner that recognizes that such traffic is more likely to be interstate or
international than intrastate. See id. Additionally, appropriate weighting of the higher revenue that is often
associated with toll service must be reflected in the traffic study or studies. See id.
50
See Contribution Methodology Order, 17 FCC Rcd at 24970, n.95.
Instructions — Page 25
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Line 422. — Show the portion of the uncollectible revenue/bad debt expense reported on Line 421 that is
associated with just the universal service contribution base amounts reported on Line 420. Filers that
maintain separate detail of uncollectibles by type of business should rely on those records in determining
the portion of gross uncollectibles reported on Line 421 that should be reported on Line 422. Filers that
do not have such detail should make such assignments in proportion to reported gross revenues. Filers
must be able to document how the amounts reported on Line 422 relate to the uncollectible revenue/bad
debt expense associated with gross billed revenues reported on Line 421.
In exceptional circumstances, amounts reported on Line 422 may exceed amounts reported on Line 421 or
either amount might actually be negative. These situations can arise where amounts previously written
off as uncollectible subsequently are collected.
Line 423. — Net universal service contribution base revenues should equal the amounts reported on Line
420 minus the amounts reported on Line 422.
5.
Notes for Carriers That Use the USOA
The revenue accounts in the USOA generally correspond to specific revenue lines in Block 3 and Block 4.
For example, revenue amounts recorded in accounts 5001, 5002, 5050, 5060 and 5069 should be reported
on Line 303 or Line 404, as appropriate. Similarly, revenues recorded in account 5280 should be reported
on Line 407. There are some exceptions. For example, local exchange carrier revenues from mobile
carriers for calls between wireless and wireline customers should be reported on Line 304. Monthly and
connection revenues from mobile services provided to end users in account 5004 should be reported on
Line 409. Per-minute revenues from end users in account 5004 should be reported on Line 410.
However, revenues in account 5004 from exchanging traffic with mobile service carriers should be
reported on Line 304. Similarly, state per-minute access revenues recorded in account 5084 should be
reported on Line 304; state special access revenues recorded in account 5084 should be reported on Line
305 and Line 406, as appropriate; and state subscriber line charge revenues recorded in account 5084
should be reported on Line 405. Uncollectible revenue recorded in account 5300 should be reported on
Line 421. The portion of these revenues that correspond to contribution base revenues should be reported
on Line 422.
Revenues classified in account 5200, miscellaneous revenues, should be divided into several lines for
reporting purposes. For example, account 5200 includes revenues derived from unbundled network
elements, which should be reported on Line 303 and, reciprocal compensation, which should be reported
on Line 304. Some types of incidental regulated revenues contained in account 5200, miscellaneous
revenues, will continue to be reported on Lines 403 through 408. These include collection overages and
non-refundable prepaid amounts that are not used by the customer. Note that late payment charges, bad
check penalties imposed by the company, enhanced services, billing and collection, customer premises
equipment sale, lease or insurance, and published directory revenues should continue to be reported on
Line 418.
Revenues recorded in account 5100, long distance network service revenues, should be reported on Line
310 through Line 314 and Line 411 through Line 417, as appropriate. Revenues from account 5100, long
distance message revenues, are normally revenues from ordinary long distance and other switched toll
services and should be reported on Lines 311, 414.1, and 414.2 except for amounts properly reported on
Lines 310, 407, 411, 412, and 413.
D.
Block 5: Additional Revenue Breakouts
Line 501. — Enter the Filer 499 ID from Line 101.
Line 502. — Enter the legal name of the filer from Line 102.
Instructions — Page 26
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Lines 503–510. — In these lines, filers should identify the percentages of their telecommunications
revenues by LNPA region. Payphone service providers, private service providers, and shared-tenant
service providers that have certified that they are exempt from contributing to the shared costs of LNP
need not provide these breakdowns. Carriers and interconnected VoIP providers should calculate or
estimate the percentage of revenues that they billed in each region based on the amount of service they
actually provided in the parts of the United States listed for each region. The percentages in column (a)
should add to 100% unless the filer did not provide any services for resale by other contributors to the
federal universal service support mechanisms. The percentages in column (b) should add to 100% unless
the filer did not provide any telecommunications services to end users or non-contributing carriers.
Carriers do not need to complete column (a) if they have some end-user revenues in each of the regions in
which they have carrier operations. Filers may use a proxy based on the percentage of subscribers a
provider serves in a particular region for reaching an estimate for allocating their end-user revenues to the
appropriate regional LNPA.
Line 511. — Identify revenues from resellers that do not contribute to universal service support
mechanisms and that are included in Block 4. Revenues from resellers that do not contribute to universal
service support mechanisms are included on Line 420 but may be excluded from a filer’s TRS, NANPA,
LNP, and FCC interstate telephone service provider regulatory fee contribution bases. To have these
amounts excluded, the filer has the option of identifying such revenues on Line 511. Line 420 may
contain revenues from some FCC Form 499 filers that are exempt from contributing directly to universal
service support mechanisms. For example, these would include filers that meet the universal service de
minimis exception or that provide “international only” service. Since these universal service exempt
entities generally do contribute directly to the TRS, LNP, and NANPA mechanisms, revenues from these
entities need not be included in the underlying service provider contribution bases for those mechanisms.
Filers choosing to report revenues on Line 511 must have the FCC Filer 499 ID for each customer whose
revenues are so reported.
Line 512. — TRS contribution base revenues reportable on Line 512(a) should equal the subtotal of Lines
403(a) through 417(a) and Line 418.4(a) less Line 511(a). TRS contribution base revenues reportable on
Line 512(b) should equal the subtotal of Lines 403(d) through 417(d), Lines 403(e) through 417(e), Line
418.4(d), and Line 418.4(e) less Line 511(b). The totals on this line represent gross end-user revenues for
the purpose of determining contributions to TRS.
Line 513. — Show the portion of the uncollectible revenue/bad debt expense reported on Line 421 that is
associated with just the TRS contribution base amounts reported on Line 512. Filers that maintain
separate detail of uncollectibles by type of business should rely on those records in determining the
portion of gross uncollectibles reported on Line 421 that should be reported on Line 513. Filers that do
not have such detail should make such assignments in proportion to reported gross revenues. Filers must
be able to document how the amounts reported on Line 513 relate to the uncollectible revenue/bad debt
expense associated with gross billed revenues reported on Line 421.
In exceptional circumstances, amounts reported on Line 513 may exceed amounts reported on Line 421 or
either amount might actually be negative. These situations can arise where amounts previously written
off as uncollectible subsequently are collected.
Line 514. — Net TRS contribution base revenues should equal the amounts reported on Line 512 less the
amounts reported on Line 513.
E.
Block 6: Certification
Line 601. — Copy the Filer 499 ID from Line 101.
Line 602. — Copy the legal name of the filer from Line 102.
Instructions — Page 27
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Line 603. — In this line, filers may certify that they are exempt from one or more contribution
requirement(s) by checking the box next to the mechanism(s) from which they are exempt. As explained
above, the FCC Form 499 Telecommunications Reporting Worksheet enables telecommunications
carriers and service providers to satisfy a number of requirements in one consolidated form. Not all
entities that file the Telecommunications Reporting Worksheet must contribute to all of the support and
cost-recovery mechanisms (universal service, LNP, TRS, and NANPA). For example, certain
telecommunications providers that are not telecommunications carriers must contribute to the universal
service support mechanisms, but not to the TRS, LNP, and NANPA mechanisms. Section IV.A provides
summary information on which filers must contribute and which filers are exempt from particular
contribution requirements. Filers that certify that they are exempt from one or more mechanism(s) should
use the space provided on Line 603 to explain the exemption.
Note: It is not necessary for a filer to certify that it is de minimis for universal service purposes because
the universal service administrator can determine whether a filer meets the contribution threshold from
other information provided on the form. If, however, a reseller or other provider of telecommunications
qualifies for the de minimis exemption, it must notify its underlying carriers that it is not contributing
directly to universal service, so that it may be treated as an end user when the underlying carriers file FCC
Form 499.
Line 604. — In this line, filers indicate whether they are exempt from FCC regulatory fees or the filer is
an “exempt telecommunications company.” 51 A state or local governmental entity is any state,
possession, city, county, town, village, municipal corporation, or similar political organization. 52 The
second check box identifies organizations duly qualified as a nonprofit, tax exempt entity under section
501 of the Internal Revenue Code, 26 U.S.C. § 501 or by state certification. 53 These organizations
typically qualify for non-profit status under sections 501(c)(3) or 501(c)(12). Note that such entities are
not exempt from universal service, TRS, LNP, or NANPA contributions unless they qualify under some
other exemption.
Line 605. — Filers may use the box in Line 605 to request nondisclosure of the revenue information
contained on the Telecommunications Reporting Worksheet. By checking this box, the officer of the
company signing the Worksheet certifies that the information contained on the Worksheet is privileged or
confidential commercial or financial information and that disclosure of such information would likely
cause substantial harm to the competitive position of the company filing the Worksheet. This box may be
checked in lieu of submitting a separate request for confidentiality pursuant to section 0.459 of the
Commission’s rules. 54 All decisions regarding disclosure of company-specific information will be made
by the Commission. The Commission regularly makes publicly available the names (and Block 1 and 2B contact information) of the entities that file the Telecommunications Reporting Worksheet and
information on which filers contribute to which funding mechanisms, including entities that checked the
boxes in Line 603.
51
47 C.F.R. § 1.1162(c). The FCC will presume that otherwise exempt carriers prefer to pay FCC regulatory fees
unless they check this box.
52
47 C.F.R. § 1.1162(b).
53
47 C.F.R. § 1.1162(c).
54
47 C.F.R. § 0.459; see also Examination of Current Policy Concerning the Treatment of Confidential Information
Submitted to the Commission, GC Docket No. 96-55, Report and Order, 13 FCC Rcd 24816 (1998) (listing the
showings required in a request that information be withheld and stating that the Commission may defer action on
such requests until a formal request for public inspection has been made).
Instructions — Page 28
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Lines 606–611. — An officer of the filer must examine the data provided in the Telecommunications
Reporting Worksheet and certify that the information provided therein is accurate and complete. Officers
of entities making consolidated filings should refer to section II.C and must certify that they comply with
the conditions listed in that section. An officer is a person who occupies a position specified in the
corporate by-laws (or partnership agreement), and would typically be president, vice president for
operations, vice president for finance, comptroller, treasurer, or a comparable position. If the filer is a
sole proprietorship, the owner must sign the certification. The signature on Line 606 must be in ink.
Filers have the opportunity to enter data, and to verify, submit, and certify FCC Forms 499-A and 499-Q
online via a web-based data entry system. Company officers, who have previously filed a signed paper
form, may certify subsequent forms online without being required to submit signed paper forms. For
those officers, an electronic signature in the signature block of each form certified by that officer will be
considered the equivalent to a handwritten signature on the form. By entering his or her electronic
signature into the signature block of each form, the officer, therefore, acknowledges that such electronic
signature certifies his or her identity and attests under penalty of perjury as to the truth and accuracy of
the information contained in each electronically signed form. Visit http://www.universalservice.org/fundadministration/forms for more information and access to the online filing system.
A person who willfully makes false statements on the Worksheet can be punished by fine or
imprisonment under Title 18 of the United States Code. 55
Line 612. — Indicate whether this filing is an original filing for the year, due on April 1, a registration
filing for a new service provider, a filing with revised registration information, or a filing with revised
revenue information. See sections II.B and II.D for information on the obligation to file revisions.
IV.
Calculation of Contributions
A.
Contribution Requirements
Most filers must contribute to the universal service, TRS, NANPA, and LNPA funding mechanisms. This
section provides a short summary to assist carriers and service providers in determining whether they
must contribute to one or more of the mechanisms. Filers should consult the Commission’s rules and
orders to determine whether they must contribute to one or more of the mechanisms.
Federal Universal Service Fund. — Entities that provide interstate telecommunications to the public for a
fee as well as certain other providers of interstate telecommunications must contribute to the universal
service support mechanisms. See 47 C.F.R. § 54.706.
Telecommunications Relay Services. — Every common carrier providing interstate telecommunications
services and every interconnected and non-interconnected VoIP provider must contribute to the TRS
Fund. See 47 C.F.R. §§ 64.601(b), 64.604.
North American Numbering Plan Administration. — All telecommunications carriers and interconnected
VoIP providers in the United States shall contribute to meet the costs of establishing numbering
administration. See 47 C.F.R. § 52.17.
Shared Costs of Local Number Portability. — The shared costs of long-term number portability
attributable to a regional database shall be recovered from all telecommunications carriers and
interconnected VoIP providers providing service in that region. See 47 C.F.R. § 52.32.
Table 2 summarizes which telecommunications carriers and service providers must file for particular
purposes. This chart is provided for informational purposes only. It is not intended to be exhaustive, nor
55
See 18 U.S.C. § 1001.
Instructions — Page 29
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
is it intended to serve as legal guidance or precedent. Filers are instructed to consult the Commission’s
rules and orders to determine whether they must contribute to one or more of the mechanisms. See 47
C.F.R. §§ 52.17, 52.32, 54.706, 64.604.
Table 2: Which Telecommunications Providers Must Contribute for Which Purposes
Type of filer
Universal Service
TRS
Non-interconnected VoIP providers with no other
telecommunications revenues
X
De minimis payphone aggregators that do not also
have telecommunications carrier revenues
X
Other payphone aggregators that do not also have
telecommunications carrier revenues
X
NANPA
LNPA
X
X
X
De minimis telecommunications providers (including
audio-bridging service providers) with no
telecommunications service revenues
Other telecommunications providers (including audiobridging providers) with no telecommunications
service revenues
X
Telecommunications carriers that provide only
intrastate service or services only to other universal
service contributors
Telecommunications carriers that provide only
international services
X
X
X
De minimis interstate telecommunications carriers
(including satellite carriers and common-carriage
stand-alone audio-bridging service providers) and de
minimis interconnected VoIP providers
X
X
X
X
X
X
All other interstate telecommunications carriers
(including satellite carriers and common-carriage
stand-alone audio-bridging service providers) and all
other interconnected VoIP providers
Instructions — Page 30
X
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
B.
Contribution Bases
Filers do not calculate the amounts that they must contribute in this Worksheet. The administrators will
use the revenue information on the Worksheet to calculate a funding base and individual contributions for
each support mechanism. Individual contributions are determined by the use of “factors”—factors reflect
the total funding requirement of a particular mechanism divided by the total contribution base for that
mechanism. Information on the contribution bases and individual filer contributions are shown below in
Table 3.
Table 3: Contribution Bases
Support Mechanism
Funding Basis
Universal service
less
Line 423(d) + Line 423(e)*
revenues corresponding to universal
service contributions**
Line 514(b)
TRS
(Filers with interstate or international enduser revenues must pay a minimum of
$25)
NANPA
(Filers with end-user revenues must pay a
minimum of $25. Filers with no end-user
revenues must pay $25.)
LNPA - by region
(Filers with only carrier’s carrier revenue
in a region must pay $100 for that region)
*
plus
less
Line 420(a)
Line 412(a)
Line 511(a)
plus
less
times
Line 420(a)
Line 412(a)
Line 511(a)
percentages on Lines 503 through 509
Line 423(e) is excluded from the contribution base if the total of amounts on Line 423(d) for the
filer consolidated with all affiliates is less than 12% of the total of Line 423(d) + Line 423(e) for the
filer consolidated with all affiliates. See 47 C.F.R. § 54.706(c).
** The contribution base for an individual filer is the projected collected interstate and international
revenues for the quarter, reduced by an imputed amount of universal service support pass-through
charges, based on the actual factor for the quarter. See Contribution Methodology Order, 17 FCC
Rcd 24952; see, e.g., Proposed First Quarter 2004 Universal Service Contribution Factor, CC
Docket No. 96-45, Public Notice, 18 FCC Rcd 25111 (2003).
Monthly billings for universal service are based on projected collected revenue information filed on the
quarterly FCC Form 499-Q. Historical amounts reported on FCC Form 499-Q Line 116(b) and (c)
correspond to FCC Form 499-A Line 420(d) and (e), respectively. The FCC Form 499-Q provides
instructions for projecting revenues, and for removing uncollectible amounts from billed revenue
projections. Projected collected revenues on FCC Form 499-Q Line 120(b) and (c) correspond to net
universal service base revenues on FCC Form 499-A Line 423(d) and (e), respectively. The amounts
filed on the FCC Form 499-A are used to review and true-up FCC Form 499-Q filings and associated
contributions.
Instructions — Page 31
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
V.
Additional Information
A.
Reminders
File the FCC Form 499-A online at http://forms.universalservice.org.
Filers are required to maintain records and documentation to justify information reported on
the Telecommunications Reporting Worksheet for five years. See section II.E.
Is the filer affiliated with another telecommunications provider? Each legal entity must file
separately unless they qualify for filing on a consolidated basis. See section II.C. Each
affiliate or subsidiary must show the same holding company information on Lines 106.1 and
106.2.
Provide data for all lines that apply. Show a zero for services for which the filer had no
revenues for the filing period.
Be sure to include on Line 112 all names by which the filer is known to customers, including
the names of agents or billers if those names appear on customer bills.
Telecommunications providers that are required to contribute to universal service support
mechanisms must also file quarterly FCC Forms 499-Q. See section II.B.
Wherever possible, revenue information should be taken from the filer’s financial records.
The Worksheet must be signed by an officer of the filer. An officer is a person who occupies
a position specified in the corporate by-laws (or partnership agreement), and would typically
be president, vice president for operations, comptroller, treasurer, or a comparable position.
Do not mail the Worksheet to the FCC. See section II.B.
Filers must re-file parts of the Worksheet if the Agent for Service of Process or FCC
Registration information changes during the year.
FCC Form 499 is one of several forms that telecommunications carriers and other providers of interstate
telecommunications may need to file. Information concerning common filing requirements for such
providers may be found on the Commission’s web site, at http://www.fcc.gov/wcb/filing.html.
B.
Contact Information
If you have questions about the Worksheet or the instructions, please contact:
Universal Service Administrator
[email protected]
(888) 641-8722
Wireline Competition Bureau
Industry Analysis and Technology Division
(202) 418-0940
(202) 418-0484 (TTY)
If you have questions regarding contribution amounts, billing procedures, or the support and cost recovery
mechanisms, you may contact:
Universal Service Administrator
(888) 641-8722
TRS Administrator
(973) 884-8334
NANPA Billing and Collection Agent
(613) 236-9191
Local Number Portability Administrators
(877) 245-5277
Instructions — Page 32
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
C.
Paperwork Reduction Act Notice
Section 52.17 of the Federal Communications Commission’s rules require all telecommunications carriers
and interconnected VoIP providers to contribute to meet the costs of establishing numbering
administration, and directs that contributions shall be calculated and paid in accordance with the FCC
Form 499-A or Worksheet. 47 C.F.R. § 52.17. Section 52.32 requires the local number portability
administrators shall recover the shared costs of long-term number portability from all telecommunications
carriers and interconnected VoIP providers. 47 C.F.R. § 52.32. Sections 54.706, 54.711, and 54.713
require all interstate telecommunications carriers, interconnected VoIP providers, providers that offer
interstate telecommunications for a fee on a non-common carrier basis, and payphone providers that are
aggregators to contribute to universal service and file this Worksheet once a year and the FCC Form 499Q four times a year. 47 C.F.R. §§ 54.706, 54.711, 54.713. Section 64.604 requires that every common
carrier and interconnected VoIP provider contribute to the TRS Fund on the basis of its relative share of
interstate end-user telecommunications revenues based on information provided in this Worksheet. 47
C.F.R. §§ 64.601(b), 64.604(c)(5)(iii)(B). Section 64.1195 and the Commission’s orders require all
telecommunications carriers and interconnected VoIP providers to register using the FCC Form 499-A.
47 C.F.R. § 64.1195(a).
This collection of information stems from the Commission’s authority under sections 151(i), 225, 251,
254, and 258 of the Communications Act of 1934, as amended, 47 U.S.C. §§ 151(i), 225, 251, 254, 258.
The data in the Worksheet will be used to calculate contributions to the universal service support
mechanisms, the TRS support mechanism, the cost recovery mechanism for numbering administration,
and the cost recovery mechanism for shared costs of long-term number portability. Selected information
provided in the Worksheet will be made available to the public in a manner consistent with the
Commission’s rules.
We have estimated that each response to this collection of information will take, on average, 13.5 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 the
Federal Communications Commission, AMD-PERM, Washington, D.C. 20554, Paperwork Reduction
Project (3060-0855). We also will accept your comments via the Internet if you send them to
[email protected]. DO NOT SEND COMPLETED WORKSHEETS 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 Office of
Management and Budget (OMB) control number. This collection has been assigned an OMB control
number of 3060-0855.
The Commission is authorized under the Communications Act to collect the information we request on
this form. We will use the information that you provide to determine contribution amounts. If we believe
there may be a violation or potential violation of a statute or a Commission regulation, rule, or order, your
Worksheet 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 Worksheet may be disclosed to the Department of Justice, court, or other adjudicative
body when (a) the Commission; or (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.
With the exception of your employer identification number, if you do not provide the information we
request on the Worksheet, the Commission may consider you in violation of rules 1.47, 52.17, 52.32,
54.713, 64.604, and 64.1195. 47 C.F.R. §§ 1.47, 52.17, 52.32, 54.713, 64.604, 64.1195.
The foregoing notice is required by the Paperwork Reduction Act of 1995, P.L. No. 104-13, 44 U.S.C.
§ 3501, et seq.
Instructions — Page 33
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Appendix A
How to determine if a filer meets the universal service de minimis standard for 2011
(1)
Interstate contribution base for filer
Enter Line 423(d) from FCC Form 499-A.
$
(2)
International contribution base for filer
Enter Line 423(e) from FCC Form 499-A.
$
(3)
Interstate contribution base for all affiliates*
Enter sum of Line 423(d) from FCC Forms 499-A of all affiliates.
$
(4)
International contribution base for all affiliates*
Enter sum of Line 423(e) from FCC Forms 499-A of all affiliates.
$
(5)
Consolidated interstate contribution base
Enter Line (1) + Line (3).
$
(6)
Consolidated interstate and international contribution base
Enter Line (2) + Line (4) + Line (5).
$
(7)
Consolidated interstate contribution base as a percentage of
consolidated interstate and international contribution base
Enter Line (5) / Line (6).
(8)
LIRE Exemption
If Line (7) > 12%, enter Line (2).
If Line (7) ≤ 12%, enter $0.
$
(9)
Contribution base to determine de minimis qualification
Enter Line (1) + Line (8).
$
(10)
2011 de minimis estimation factor
.142**
(11)
Estimated annual contribution
Enter Line (9) x Line (10)
$
*
%
Unless otherwise specifically provided, an affiliate is a “person that (directly or indirectly) owns or
controls, is owned or controlled by, or is under common ownership or control with, another person.”
For this purpose, the term ‘owns’ means to own an equity interest (or the equivalent thereof) of more
than 10 percent. See 47 U.S.C. § 153(1).
** The estimation factor is based on a contribution factor of .165, which is higher than the contribution
factor announced for any quarter of 2010, and a corresponding circularity factor of .141631. Actual
contribution and circularity factors for 2011 may increase or decrease depending on quarterly changes
in program costs and the projected contribution base. Filers whose actual contribution requirements
total less than $10,000 for the calendar year will be treated as de minimis and will receive refunds, if
necessary. Filers whose actual contribution requirements total $10,000 or more are required to
contribute to the universal service support mechanisms. Note that telecommunications carriers and
interconnected VoIP service providers must file this Worksheet regardless of whether they qualify for
the de minimis exemption. Telecommunications providers may qualify for one of the exemptions to
filing detailed in sections II.A.2 or II.A.3.
Instructions — Page 34
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
Appendix B
Explanation of categories listed in Line 105
CAP/CLEC (Competitive Access Provider/Competitive Local Exchange Carrier). — Competes with
incumbent local exchange carriers (ILECs) to provide local exchange services, or telecommunications
services that link customers with interexchange facilities, local exchange networks, or other customers,
other than Coaxial Cable providers.
Cellular/PCS/SMR (Cellular, Personal Communications Service, and Specialized Mobile Radio). —
Provides primarily wireless telecommunications services (wireless telephony). This category includes all
providers of real-time two-way or push-to-talk switched voice services that interconnect with the public
switched network, including providers of prepaid phones and public coast stations interconnected with the
public switched network. See 47 C.F.R. § 80.451. This category includes the provision of wireless
telephony by resale. An SMR provider would select this category if it primarily provides wireless
telephony rather than dispatch or other mobile services.
Coaxial Cable. — Uses coaxial cable (cable TV) facilities to provide local exchange services or
telecommunications services that link customers with interexchange facilities, local exchange networks,
or other customers.
ILEC (Incumbent Local Exchange Carrier). — Provides local exchange service. An incumbent LEC
or ILEC generally is a carrier that was at one time franchised as a monopoly service provider or has since
been found to be an incumbent LEC. See 47 U.S.C. § 251(h).
IXC (Interexchange Carrier). — Provides long distance telecommunications services substantially
through switches or circuits that it owns or leases.
Interconnected VoIP Provider. — Provides “interconnected VoIP service,” which is a service that
(1) enables real-time, two-way voice communications; (2) requires a broadband connection from the
user’s location; (3) requires Internet protocol-compatible customer premises equipment (CPE); and
(4) permits users generally to receive calls that originate on the public switched telephone network and to
terminate calls to the public switched telephone network.
Local Reseller. — Provides local exchange or fixed telecommunications services by reselling services of
other carriers.
Non-Interconnected VoIP Provider. — Provides non-interconnected VoIP service, which is a service
that (i) enables real-time voice communications that originate from or terminate to the user’s location
using Internet protocol or any successor protocol and (ii) requires Internet Protocol compatible customer
premises equipment, but (iii) is not an interconnected VoIP service.
Operator Service Provider (OSP). — Serves customers needing the assistance of an operator to
complete calls, or needing alternate billing arrangements such as collect calling.
Paging and Messaging. — Provides wireless paging or wireless messaging services. This category
includes the provision of paging and messaging services by resale.
Payphone Service Provider. — Provides customers access to telephone networks through payphone
equipment, special teleconference rooms, etc. Payphone service providers also are referred to as
payphone aggregators.
Prepaid Calling Card Provider. — Provides prepaid calling card services by selling prepaid calling
cards to the public, to distributors or to retailers. Prepaid card providers provide consumers the ability to
place long distance calls without presubscribing to an interexchange carrier or using a credit card.
Prepaid card providers typically resell the toll service of other carriers and determine the price of the
service by setting the price of the card, assigning personal identification numbers (PINs) and controlling
Instructions — Page 35
2012 Instructions to the Telecommunications Reporting Worksheet, Form 499-A
the number of minutes that the card can be used for. Companies who simply sell cards created by others
are marketing agents and do not file.
Private Service Provider. — Offers telecommunications to others for a fee on a non-common carrier
basis. This would include a company that offers excess capacity on a private system that it uses primarily
for internal purposes. This category does not include SMR or Satellite Service Providers.
Satellite Service Provider. — Provides satellite space segment or earth stations that are used for
telecommunications service.
Shared-Tenant Service Provider /Building LEC. — Manages or owns a multi-tenant location that
provides telecommunications services or facilities to the tenants for a fee.
SMR (dispatch) (Specialized Mobile Radio Service Provider). — Primarily provides dispatch services
and mobile services other than wireless telephony. While dispatch services may include interconnection
with the public switched network, this category does not include carriers that primarily offer wireless
telephony. This category includes LTR dispatch or community repeater systems.
Stand-Alone Audio Bridging Provider /Integrated Teleconferencing Service Provider. — Allows
end users to transmit a call (using telephone lines), to a point specified by the user (the conference
bridge), without change in the form or content of the information as sent and received (voice
transmission).
Toll Reseller. — Provides long distance telecommunications services primarily by reselling the long
distance telecommunications services of other carriers.
Wireless Data. — Provides mobile or fixed wireless data services using wireless technology. This
category includes the provision of wireless data services by resale.
The Worksheet also provides boxes for “Other Local,” “Other Mobile,” and “Other Toll.” If one of these
categories is checked, the filer should describe the nature of the service it provides under the check boxes.
For example, filers that provide toll service that: (1) uses ordinary customer premises equipment with no
enhanced functionality; (2) originates and terminates on the public switched telephone network and
(3) undergoes no net protocol conversion and provides no enhanced functionality to end users due to the
provider’s use of IP technology should enter “VoIP toll” in the explanation field. 56
56
See AT&T IP-in-the-Middle Order, 19 FCC Rcd at 7457–58, para. 1.
Instructions — Page 36
2012 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2011 Revenues)
DRAFT - NOT YET APPROVED BY OMB
3060-0855
>>> Please read instructions before completing. <<<
Annual Filing -- due April 1, 2012
Block 1: Contributor Identification Information
101
During the year, filers must refile Blocks 1, 2 and 6 if there are any changes in Lines 104 or 112. See Instructions.
Filer 499 ID [If you don't know your number, contact the administrator at (888) 641-8722.
If you are a new filer, write "NEW" in this block and a Filer 499 ID will be assigned to you.]
102
Legal name of filer
103
IRS employer identification number
104
Name filer is doing business as
105
Telecommunications activities of filer [Select up to 5 boxes that best describe the reporting entity. Enter numbers starting with "1" to show the order of importance -- see instructions.]
[Enter 9 digit number]
Audio Bridging (teleconferencing) Provider
CAP/CLEC
Incumbent LEC
Interconnected VoIP
Interexchange Carrier (IXC)
Local Reseller
Non-Interconnected VoIP
Operater Service Provider
Paging & Messaging
Payphone Service Provider
Prepaid Card
Private Service Provider
Satellite Service Provider
Shared-Tenant Service Provider / Building LEC
Toll Reseller
Wireless Data
Other Mobile
Other Toll
If Other Local, Other Mobile or Other Toll is checked,
Cellular/PCS/SMR (wireless telephony incl. by resale)
SMR (dispatch)
Other Local
Coaxial Cable
describe carrier type / services provided:
106.1
Holding company name (All affiliated companies must show the same name on this line.)
106.2
Holding company IRS employer identification number
[Enter 9 digit number]
107
FCC Registration Number (FRN) [https://fjallfoss.fcc.gov/coresWeb/publicHome.do]
[For assistance, contact the CORES help desk at 877-480-3201 or [email protected]]
[Enter 10 digit number]
108
109
Management company [if filer is managed by another entity]
Complete mailing address of reporting entity
corporate headquarters
110
Complete business address for customer inquiries and complaints
check if same address as Line 109
Street1
Street2
Street3
City
Street1
Street2
Street3
City
(
State
Zip (postal code)
Country if not USA
State
Zip (postal code)
Country if not USA
111
Telephone number for customer complaints and inquiries [Toll-free number if available]
112
List all trade names used in the past 3 years in providing telecommunications. Include all names by which you are known by customers.
a
g
b
h
c
i
d
j
e
k
f
l
Use an additional sheet if necessary. Each filer must provide all names used for telecommunications activities.
)
-
ext -
PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. § 1001
Save time, avoid problems -- file electronically at
http://forms.universalservice.org
FCC Form 499-A / February 2012
2012 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2011 Revenues)
Page 2
Block 2-A: Regulatory Contact Information
201
202
203
204
205
206
207
Filer 499 ID [from Line 101]
Legal name of filer [from Line 102]
Person who completed this Worksheet
Telephone number of this person
Fax number of this person
Email of this person || not for public release ||
Corporate office, attn. name, and mailing
address to which future Telecommunications
Reporting Worksheets should be sent
check if same name as Line 203
check if same address as Line 109
208
Billing address and billing contact person
[Plan administrators will send bills for contributions to this
address. Please attach a written request for alternative
billing arrangements. ]
check if name and address same as Line 207
First
MI
(
(
Block 2-B: Agent for Service of Process
Last
-
Office
ext -
Attn: First name
Phone
Email ||not for public release||
Street1
Street2
Street3
City
State
MI
(
)
-
Zip (postal code)
Company
Attn: First name
Phone
Email ||not for public release||
Street1
Street2
Street3
City
208.1 Email address where ITSP regulatory fee bill should be sent
)
)
State
Last
ext-
Fax
(
)
-
(
)
-
Country if not USA
MI
(
)
-
Zip (postal code)
Last
ext-
Fax
Country if not USA
||not for public release||
All carriers and providers of interconnected and non-interconnected VoIP must complete Lines 209 through 213. During the year,
these filers must refile Blocks 1, 2, and 6 if there are any changes in this section. See Instructions.
209
210
211
212
D.C. Agent for Service of Process
Telephone number of D.C. agent
Fax number of D.C. agent
Email of D.C. agent
Company
213
Complete business address of D.C. agent
for hand service of documents
Street1
Street2
Street3
City
Attn First name
(
(
214
215
216
217
Local/alternate Agent for Service of Process (optional)
Telephone number of local/alternate agent
Fax number of local/alternate agent
Email of local/alternate agent
Company
218
Complete business address of local/alternate
agent for hand service of documents
Street1
Street2
Street3
City
)
)
State
-
ext -
DC
Zip
Attn First name
(
(
)
)
State
-
MI
Last
MI
Last
ext -
Zip (postal code)
Country if not USA
PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. § 1001
Save time, avoid problems -- file electronically at
http://forms.universalservice.org
FCC Form 499-A / February 2012
2012 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2011 Revenues)
Block 2-C: FCC Registration and Contact Information
219
220
221
222
Page 3
Filers must refile Blocks 1, 2 and 6
if there are any changes in this section. See Instructions.
Filer 499 ID [from Line 101]
Legal name of filer [from Line 102]
Chief Executive Officer (or, highest ranking company officer
if the filer does not have a chief executive officer)
Business address of individual named on Line 221
First
MI
Last
Street1
Street2
check if same as Line 109
223
224
Street3
City
State
First
Second ranking company officer, such as Chairman
(Must be someone other than the individual listed on Line 221)
Street1
Business address of individual named on Line 223
Zip (postal code)
MI
Country if not USA
Last
Street2
check if same as Line 109
225
226
Street3
City
Third ranking company officer, such as President or Secretary
(Must be someone other than individuals listed on
Lines 221 and 223)
Business address of individual named on Line 225
State
First
Zip (postal code)
MI
Country if not USA
Last
Street1
Street2
check if same as Line 109
227
228
Street3
City
State
Zip (postal code)
Country if not USA
Indicate jurisdictions in which the filer provides service. Include jurisdictions in which service was provided in the past 15 months
and jurisdictions in which service is likely to be provided in the next 12 months.
Alabama
Guam
Massachusetts
New York
Tennessee
Alaska
Hawaii
Michigan
North Carolina
Texas
American Samoa
Idaho
Midway Atoll
North Dakota
Utah
Arizona
Illinois
Minnesota
Northern Mariana Islands
U.S. Virgin Islands
Arkansas
Indiana
Mississippi
Ohio
Vermont
California
Iowa
Missouri
Oklahoma
Virginia
Colorado
Johnston Atoll
Montana
Oregon
Wake Island
Connecticut
Kansas
Nebraska
Pennsylvania
Washington
Delaware
Kentucky
Nevada
Puerto Rico
West Virginia
District of Columbia
Louisiana
New Hampshire
Rhode Island
Wisconsin
Florida
Maine
New Jersey
South Carolina
Wyoming
Georgia
Maryland
New Mexico
South Dakota
Year and month filer first provided (or expects to provide) telecommunications in the U.S.
Check if prior to 1/1/1999, otherwise:
Year
Month
PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. § 1001
Save time, avoid problems -- file electronically at
http://forms.universalservice.org
FCC Form 499-A / February 2012
2012 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2011 Revenues)
Page 4
Block 3: Carrier's Carrier Revenue Information
301
Filer 499 ID [from Line 101]
302
Legal name of filer [from Line 102]
Report billed revenues for January 1 through December 31, 2011.
Do not report any negative numbers. Dollar amounts may be rounded to
the nearest thousand dollars. However, report all amounts as whole dollars.
See instructions regarding percent interstate and international.
Revenues from Services Provided for Resale as Telecommunications
by Other Contributors to Federal Universal Service Support Mechanisms
Total
Revenues
(a)
If breakouts are not book
amounts, enter whole
percentage estimates
Interstate International
(b)
(c)
Breakouts
Interstate
Revenues
(d)
International
Revenues
(e)
Fixed local service
Monthly service, local calling, connection charges, vertical features,
and other local exchange service including subscriber line and
PICC charges to IXCs
303.1
Provided as unbundled network elements (UNEs)
303.2
Provided under other arrangements
Per-minute charges for originating or terminating calls
304.1
Provided under state or federal access tariff
304.2
Provided as unbundled network elements or other contract arrangement
Local private line & special access service
305.1
Provided to other contributors for resale as telecommunications
305.2
Provided to other contributors for resale as interconnected VoIP
306
Payphone compensation from toll carriers
307
Other local telecommunications service revenues
308
Universal service support revenues received from Federal or state sources
Mobile services (i.e., wireless telephony, paging, messaging, and other mobile services)
309
Monthly, activation, and message charges except toll
Toll services
310
Operator and toll calls with alternative billing arrangements (credit card,
collect, international call-back, etc.)
311
Ordinary long distance (direct-dialed MTS, customer toll-free (800/888
etc.) service, "10-10" calls, associated monthly account maintenance,
PICC pass-through, and other switched services not reported above)
312
Long distance private line services
313
Satellite services
314
All other long distance services
315
Total revenues from resale [Lines 303 through 314]
Note: As stated in the instructions, for all revenues reported on this page, you must retain the Filer 499 ID and contact information for the associated
customers. You must verify that each of these customers was a direct contributor to the federal universal service support mechanism for calendar year 2010
and that the customer is purchasing service for resale as telecommunications. These records must be made available to the administrator or
the FCC upon request. The FCC website contains information on federal universal service contributors. (See instructions.)
PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. § 1001
Save time, avoid problems -- file electronically at
http://forms.universalservice.org
FCC Form 499-A / February 2012
2012 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2011 Revenues)
Page 5
Block 4-A: End-User and Non-Telecommunications Revenue Information
401
Filer 499 ID [from Line 101]
402
Legal name of filer [from Line 102]
Report billed revenues for January 1 through December 31, 2011.
Do not report any negative numbers. Dollar amounts may be rounded to
the nearest thousand dollars. However, report all amounts as whole dollars.
See instructions regarding percent interstate and international.
Revenues from All Other Sources (end-user telecom. & non-telecom.)
403
Surcharges or other amounts on bills identified as recovering
State or Federal universal service contributions
Total
Revenues
(a)
If breakouts are not book
amounts, enter whole
percentage estimates
Interstate International
(b)
(c)
Breakouts
Interstate
Revenues
(d)
International
Revenues
(e)
Fixed local services
Monthly service, local calling, connection charges, vertical features,
and other local exchange service charges except for federally
tariffed subscriber line charges and PICC charges
Traditional Circuit Switched
404.1
Provided at a flat rate including interstate toll service -- local portion
404.2
Provided at a flat rate including interstate toll service -- toll portion
404.3
Provided without interstate toll included (see instructions)
Interconnected VoIP
404.4
Offered in conjunction with a broadband connection
404.5
Offered independent of a broadband connection
405
Tariffed subscriber line charges and PICC charges levied by a local
exchange carrier on a no-PIC customer
406
Local private line & special access service [Includes the transmission
portion of wireline broadband Internet access provided on a common
carrier basis.]
407
Payphone coin revenues (local and long distance)
408
Other local telecommunications service revenues
Mobile services (i.e., wireless telephony, paging, messaging, and other mobile services)
409
Monthly and activation charges
410
Message charges including roaming and air-time charges for toll
calls, but excluding separately stated toll charges
PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. § 1001
Save time, avoid problems -- file electronically at
http://forms.universalservice.org
FCC Form 499-A / February 2012
2012 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2011 Revenues)
Page 6
Block 4-A: Continued
Total
Revenues
(a)
Toll services
411
Prepaid calling card (including card sales to customers
and non-carrier distributors) reported at face value of cards
412
International calls that both originate and terminate in foreign points
413
Operator and toll calls with alternative billing arrangements (credit
card, collect, international call-back, etc.) other than revenues
reported on Line 412
Ordinary long distance (direct-dialed MTS, customer toll-free (800/888
etc.) service , "10-10" calls, associated monthly account maintenance,
PICC pass-through, and other switched services not reported above)
414.1
All, other than interconnected VoIP, including, but not limited to,
itemized toll on wireline and wireless bills
414.2
All interconnected VoIP long distance, including, but not limited to,
itemized toll
415
Long distance private line services
416
Satellite services
417
All other long distance services
If breakouts are not book
amounts, enter whole
percentage estimates
Interstate International
(b)
(c)
0%
Breakouts
Interstate
Revenues
(d)
International
Revenues
(e)
100%
Revenues other than U.S. telecommunications revenues, including information services,
inside wiring maintenance, billing and collection customer premises equipment, published
directory, dark fiber, Internet access, cable TV program transmission, foreign carrier
operations, and non-telecommunications revenues (See instructions.)
418.1
418.2
418.3
418.4
bundled with circuit switched local exchange service
bundled with interconnected VoIP local exchange service
other
non-interconnected VoIP revenues not included in any other category
Block 4-B: Total Revenue and Uncollectible Revenue Information
419
420
421
422
423
Gross billed revenues from all sources (incl. reseller & non-telecom.)
[Lines 303 through 314 plus Lines 403 through 418]
Gross universal service contribution base amounts [Lines 403 through 411 plus
Lines 413 through 417] [See Table 3 in instructions.]
Uncollectible revenue/bad debt expense associated with gross
billed revenues amounts shown on Line 419 [See instructions.]
Uncollectible revenue/bad debt expense associated with universal
service contribution base amounts shown on Line 420
Net universal service contribution base revenues
[Line 420 less line 422]
PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. § 1001
Save time, avoid problems -- file electronically at
http://forms.universalservice.org
FCC Form 499-A / February 2012
2012 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2011 Revenues)
Page 7
Block 5: Additional Revenue Breakouts
501
Filer 499 ID [from Line 101]
502
Legal name of filer [from Line 102]
Filers that report revenues in Block 3 and Block 4 must provide the percentages requested in Lines 503 through 510.
See instructions for limited exceptions.
Percentage of revenues reported in Block 3 and Block 4 billed in each region of the country. Round or
estimate to nearest whole percentage. Enter 0 if no service was provided in the region.
503
504
505
506
507
508
509
510
511
512
513
514
Southeast:
Block 3
Carrier's
Carrier
(a)
Block 4
End-User
Telecom.
(b)
Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina,
%
Puerto Rico, South Carolina, Tennessee, and U.S. Virgin Islands
Western:
Alaska, Arizona, Colorado, Idaho, Iowa, Minnesota, Montana, Nebraska, New Mexico,
%
North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming
West Coast:
California, Hawaii, Nevada, American Samoa, Guam, Johnston Atoll, Midway Atoll,
%
Northern Mariana Islands, and Wake Island.
Mid-Atlantic: Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, Virginia, and
%
West Virginia
Mid-West:
Illinois, Indiana, Michigan, Ohio, and Wisconsin
%
Northeast:
Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont
%
Southwest:
Arkansas, Kansas, Missouri, Oklahoma, and Texas
%
Total:
[Percentages must add to 0 or 100.]
%
Revenues from resellers that do not contribute to universal service support mechanisms are included in Block 4-B, Line 420 but may be excluded from a
filer's TRS, NANPA, LNP, and FCC interstate telephone service provider regulatory fee contribution bases. To have these amounts excluded, the filer has the
option of identifying such revenues below. As stated in the instructions, you must have in your records the FCC Filer 499 ID for each customer
whose revenues are included on Line 511. (See instructions.)
(a)
(b)
Total Revenues
Interstate and International
Revenues from resellers that do not contribute to Universal Service
Gross TRS contribution base amounts
[Lines 403 through 417 plus Line 418.4 less Line 511]
Uncollectible revenue/bad debt expense associated with
TRS contribution base amounts shown on Line 512
Net TRS contribution base revenues [Line 512 less Line 513]
%
%
%
%
%
%
%
%
PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. § 1001
Save time, avoid problems -- file electronically at
http://forms.universalservice.org
FCC Form 499-A / February 2012
2012 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2011 Revenues)
Page 8
Block 6: CERTIFICATION: to be signed by an officer of the filer
601
602
Filer 499 ID [from Line 101]
Legal name of filer [from Line 102]
Section IV of the instructions provides information on which types of filers are required to file for which purposes. Any filer claiming
to be exempt from one or more contribution requirements should so certify below and attach an explanation. [The Universal Service Administrator
will determine which filers meet the de minimis threshold based on information provided in Block 4, even if you fail to so certify below.]
603
I certify that the filer is exempt from contributing to:
Universal Service
TRS
NANPA
LNP Administration
Provide explanation below:
604
Please indicate whether the filer is
State or Local Government Entity
I.R.C. § 501 or State Tax Exempt (see instructions)
605
I certify that the revenue data contained herein are privileged and confidential and that public disclosure of such information would likely cause substantial harm to the competitive
position of the company. I request nondisclosure of the revenue information contained herein pursuant to sections 0.459, 52.17, 54.711 and 64.604 of the Commission's rules.
I certify that I am an officer of the above-named filer as defined in the instructions, that I have examined the foregoing report and,
to the best of my knowledge, information and belief, all statements of fact contained in this Worksheet are true and that said Worksheet is an accurate
statement of the affairs of the above-named company for the previous calendar year. In addition, I swear, under penalty of perjury, that all
requested identification registration information has been provided and is accurate. If the above-named filer is filing on a
consolidated basis, I certify that this filing incorporates all of the revenues for the consolidated entities for the entire year and that
the filer adhered to and continues to meet the conditions set forth in section II-C of the instructions.
606
Signature
607
Printed name of officer
608
Position with reporting entity
609
Business telephone number of officer
610
Email of officer || not for public release ||
611
Date
612
Check those that apply:
First
Original April 1 filing for year
MI
(
New filer, registration only
)
Last
-
ext -
Revised filing with updated registration
Revised filing with updated revenue data
Do not mail checks with this form. Send this form to: Form 499 Data Collection Agent c/o USAC 2000 L Street, N.W. Suite 200, Washington, DC 20036
For additional information regarding this worksheet contact: Telecommunications Reporting Worksheet information: (888) 641-8722 or via email: [email protected]
PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. § 1001
Save time, avoid problems -- file electronically at
http://forms.universalservice.org
FCC Form 499-A / February 2012
| File Type | application/pdf |
| File Title | FCC Form 499 Revised, February 2011 |
| Author | Carol.Mattey |
| File Modified | 2011-03-22 |
| File Created | 2011-03-22 |