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pdf2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
FCC Form 499-A, January2017
Approved by OMB
OMB Control Number 3060-0855
Estimated Average Burden Hours Per Response: 13.5 Hours
2017 Telecommunications Reporting Worksheet Instructions
(FCC Form 499-A)
Table of Contents
I.
II.
III.
IV.
Introduction...................................................................................................................................... 2
Contact Information......................................................................................................................... 3
Filing Requirements and General Instructions................................................................................. 4
A.
Who Must File .................................................................................................................... 4
1.
General Information............................................................................................... 4
2.
Additional Information Regarding USF Contribution Requirements.................... 5
a. Exception for USF de minimis telecommunications providers....................... 6
b. Exception for government, broadcasters, schools, and libraries..................... 7
c. Exception for systems integrators and self-providers ..................................... 7
d. Filing Exemption for Marketing Agents......................................................... 8
B.
Which Telecommunications Providers Must Contribute for Which Purposes ................... 8
C.
How to File ....................................................................................................................... 11
1.
No Filing Fee ....................................................................................................... 11
2.
When to File ........................................................................................................ 11
3.
Electronic Filing .................................................................................................. 13
D.
Obligation to File Revisions ............................................................................................. 13
E.
Recordkeeping .................................................................................................................. 14
F.
Compliance ....................................................................................................................... 14
G.
Rounding of Numbers and Negative Numbers ................................................................. 14
Specific Instructions....................................................................................................................... 15
A.
Block 1: Filer Identification Information......................................................................... 15
B.
Block 2: Contact Information .......................................................................................... 17
1.
Block 2-A: Regulatory Contact Information ...................................................... 17
2.
Block 2-B: Agent for Service of Process............................................................ 18
3.
Block 2-C: FCC Registration Information.......................................................... 18
C.
Blocks 3 and 4-A: Filer Revenue Information................................................................. 19
1.
Filer Identification ............................................................................................... 20
2.
Gross Billed Revenues – General ........................................................................ 20
3.
Apportioning Revenues Among Reporting Categories ....................................... 22
a. General Information...................................................................................... 22
b. Fixed local service revenue categories.......................................................... 23
c. Mobile service categories.............................................................................. 27
d. Toll service revenue categories..................................................................... 29
e. Other revenue categories............................................................................... 32
f. Reporting revenues from bundled offerings.................................................. 33
g. Notes for carriers that use the USOA ........................................................... 34
4.
Attributing Revenues from Contributing Resellers and from End Users ............ 35
a. Definition of “Reseller” ................................................................................ 35
b. Revenues from Entities Exempt from USF Contributions............................ 36
c. “Reasonable Expectation” Standard ............................................................. 36
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2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
V.
VI.
d. Safe Harbor Procedures for Meeting the “Reasonable Expectation.”........... 37
e. Certifications................................................................................................. 37
5.
Allocating Revenues between the Jurisdictions................................................... 38
a. Definitions..................................................................................................... 38
b. General Requirements................................................................................... 38
c. Services Offered Under Interstate Tariffs ..................................................... 39
d. Flat-rate Unbundled Network Access Elements ........................................... 39
e. Mixed-Use Private or WATS Lines.............................................................. 39
f. Bundled Local and Toll Services................................................................... 39
g. Safe Harbors ................................................................................................. 39
h. Traffic Studies............................................................................................... 41
D.
Block 4-B: Total Revenue and Uncollectible Revenue Information ............................... 41
E.
Block 5: Additional Revenue Breakouts for Non-USF Mechanisms .............................. 43
F.
Block 6: Certification....................................................................................................... 45
Calculation of Contributions.......................................................................................................... 47
Additional Information .................................................................................................................. 48
A.
Reminders ......................................................................................................................... 48
B.
Paperwork Reduction Act Notice ..................................................................................... 48
Table 1:
Table 2:
Table 3:
Table 4:
Which Telecommunications Providers Must Contribute for Which Purposes…………………...8
Filing Schedule for One-Time Requirements………………………………………………….. 11
Filing Schedule for Annual Reporting Requirements…………………………………………...12
Contribution Bases………………………………………………………………………………47
Appendix A: How to determine if a filer meets the universal service de minimis standard for 2016……51
Appendix B: Explanation of categories listed in Line 105……………………………………………….52
File the FCC Form 499-A online at http://forms.universalservice.org
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 Voiceover-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
1
47 U.S.C. §§ 151, 225, 251, 254, 616.
2
See 47 CFR §§ 52.17(b), 52.32(b), 54.708, 54.711, 64.604(c)(5)(iii)(A) and (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).
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2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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 process5 and their obligations to register with
the Federal Communications Commission.6
II.
CONTACT INFORMATION
If you have questions about the Worksheet or the instructions, you may contact:
Universal Service Administrator
[email protected]
(888) 641-8722
If you have questions regarding contribution amounts, billing procedures, or the support and
cost recovery mechanisms, you may contact:
Universal Service Administrator
[email protected]
(888) 641-8722
TRS Administrator
[email protected]
(717) 585-6605
NANPA Billing and Collection Agent
[email protected]
(613) 760-4512
Local Number Portability Administrators
[email protected]
(877) 245-5277
ITSP Regulatory Fees
(877) 480-3201
4
See 47 CFR §§ 52.17 (numbering administration), 52.32 (local number portability), 54.706 (universal service),
64.604 (interstate TRS).
5
47 U.S.C. § 413; see 47 CFR § 1.47(h).
6
47 CFR § 64.1195.
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2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
III.
FILING REQUIREMENTS AND GENERAL INSTRUCTIONS
A.
WHO MUST FILE
1.
GENERAL INFORMATION
With very limited exceptions, all intrastate, interstate, and international providers of telecommunications
in the United States7 must file this Worksheet.8 In addition to filing this form 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.
FCC Form 499-A is a multi-purpose form. It is used for at least seven purposes:
Annual filing requirements:
1. Report revenues for purposes of the federal Universal Service Fund (USF);
2. Report revenues for purposes of the federal Telecommunications Relay Services Fund (TRS);
3. Report revenues for the administration of the North American Numbering Plan (NANPA);
4. Report revenues for the shared costs of local number portability administration (LNPA);
5. Report revenues for calculating and assessing Interstate Telecommunications Service Provider
(ITSP) regulatory fees;
One-time filing requirements (with obligation to revise if information changes):
6. Satisfy obligations under section 413 of the Act to designate an agent in the District of
Columbia for service of process;
7. Fulfill obligations to register with the Federal Communications Commission under 47 CFR §
64.1195.
If you are subject to one or more of the above requirements, you must file FCC Form 499-A.
1. 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 CFR § 54.706.
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(50), (51); 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 et al., WC Docket No. 06-122 et al., Report and
Order and Notice of Proposed Rulemaking, 21 FCC Rcd 7518 (2006) (2006 Contribution Methodology Reform
Order).
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2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
2. Telecommunications Relay Services — Every common carrier9 providing interstate
telecommunications services and every VoIP provider (including interconnected and non-interconnected)
must contribute to the TRS Fund. See 47 CFR §§ 64.601(b), 64.604.
3. Non-Interconnected VoIP Service Providers — All providers of “non-interconnected VoIP service”
(as defined in section 64.601(a) of the Commission’s rules) with interstate end-user revenues subject to
TRS contributions must file this Worksheet in order to register with the Commission and report their
revenues for purposes of calculating TRS contributions.10
4. 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 CFR § 52.17.
5. 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 CFR § 52.32.
6. ITSP Regulatory Fees – Congress requires the Commission to assess and collect regulatory fees “to
recover the costs of …enforcement activities, policy and rulemaking activities, user information services,
and international activities.” See 47 CFR § 159(a).
7. Designation of Agent for Service of Process – For more information on this requirement, see the
instructions for Block 2-B.
8. FCC Registration – For more information on this requirement, see the instructions for Block 2-C.
2.
ADDITIONAL INFORMATION REGARDING USF CONTRIBUTION
REQUIREMENTS
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.
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.11
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;12 access to interexchange service; business data services; wide area
9
“Common carrier” or “carrier” means “any person engaged as a common carrier for hire, in interstate or foreign
communication by wire or radio or interstate or foreign radio transmission of energy. . .” 47 U.S.C. § 153(11).
10
See Contributions to the Telecommunications Relay Services Fund, CG Docket No. 11-47, Report and Order, 26
FCC Rcd 14532, 14537, para. 12 (2011) (2011 TRS Contributions Order) (adding definition of “non-interconnected
VoIP service” to the Commission’s TRS rules at section 64.601(a)). See 47 C.F.R § 64.601(a).
11
47 U.S.C. § 153(50).
12
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).
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2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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;13 and interconnected VoIP services.
Note that all incumbent (ILEC) and competitive (CLEC) local exchange carriers provide access
services and, therefore, provide interstate telecommunications. No filing exemptions exist for
data or non-voice services.
There is no filing 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.14
Owners of pay telephones, also known as “pay telephone aggregators.”
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.
a.
Exception for USF 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 $10,000.15
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.16
Telecommunications carriers providing telecommunications services on a common-carriage basis
and interconnected VoIP providers need not contribute to the universal service support
mechanism if they meet the de minimis standard. However, they must file this Worksheet because
they must contribute to other support mechanisms (TRS, NANPA or LNPA). See section III.A.1
for information regarding contribution requirements for TRS, NANPA, and LNPA. Such
providers need not file an FCC Form 499-Q.17
13
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), petition for reconsideration denied,
Petitions for Reconsideration and Clarification of the InterCall Order, WC Docket No. 06-122, CC Docket No. 9645, Order on Reconsideration, 27 FCC Rcd 898 (2012), subsequent history omitted.
14
See 47 CFR § 54.708.
15
See id.
16
See 47 U.S.C. § 153(53).
17
Sections 54.706, 54.711, and 54.713 of the Commission’s rules require all telecommunications carriers providing
interstate telecommunications services, interconnected VoIP providers that provide interstate telecommunications,
(continued . . .)
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2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Providers who may be de minimis 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 2016
through December 2016.
b.
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:18
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 that do not offer services to others.
Broadcasters, non-profit schools, non-profit libraries, non-profit colleges, non-profit universities,
and non-profit health care providers.
c.
Exception for systems integrators and self-providers
Systems integrators: 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.19
(Continued from previous page)
providers of interstate telecommunications that offer interstate telecommunications for a fee on a non-common carrier
basis, and payphone providers that are aggregators to contribute to the universal service fund and file a FCC Form 499Q on February 1, May 1, August 1, and November 1 each year. 47 CFR §§ 54.706, 54.711, 54.713. The FCC Form
499-Q sets forth information that the contributor must submit, so that the Administrator of the universal service support
mechanisms may calculate and assess contributions. See Telecommunications Reporting Worksheet, FCC Form 499-Q
(2016) Instructions for Completing the Quarterly Worksheet for Filing Contributions to Universal Service Support
Mechanisms, OMB Control Number 3060-0855 (dated Dec. 2014).
18
See Federal-State Joint Board on Universal Service, CC Docket No. 96-45, Report and Order, 12 FCC Rcd 8776,
9187, para. 800 (1997) (Universal Service First Report and Order).
19
See Federal-State Joint Board on Universal Service; Access Charge Reform, Price Cap Performance Review for
Local Exchange Carriers, Transport Rate Structure and Pricing, End User Common Line Charge, Fourth Order on
Reconsideration, 13 FCC Rcd 5318, 5471-75 (1997).
Instructions — Page 7
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Self-Providers: Entities that provide telecommunications only to themselves or to commonly-owned
affiliates need not file.20
d.
Filing Exemption for Marketing Agents
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.
B.
WHICH TELECOMMUNICATIONS PROVIDERS MUST CONTRIBUTE FOR
WHICH PURPOSES
Table 1 summarizes which telecommunications carriers and service providers must directly contribute for
particular purposes. This chart is provided for informational purposes only. It is not intended to be
exhaustive, nor 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 CFR §§ 52.17, 52.32, 54.706, 64.604.
Table 1: 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
De minimis telecommunications providers (including
audio-bridging service providers) with no
telecommunications service revenues
Other telecommunications providers (including audio- X
bridging providers) with no telecommunications
service revenues
20
See Universal Service First Report and Order. 12 FCC Rcd at 9187, para. 800.
Instructions — Page 8
X
NANPA
LNPA
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Telecommunications carriers that provide only
intrastate service or services only to other universal
service contributors
X
X
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
X
As shown above, 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. If an entity is not required
to contribute to any of these support mechanisms, then it is not required to file this Worksheet.
For USF purposes, these non-contributors must be treated as end users by their underlying
carriers and therefore may end up contributing indirectly as a result of USF pass-through
surcharges.
Providers who do not file this Worksheet because they are de minimis for USF contribution
purposes, 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.21
Interconnected VoIP providers who are de minimis must file this Worksheet and retain the table
and documentation of their contribution base revenues for five calendar years after the date each
Worksheet is due.22
FILING BY LEGAL ENTITY
Each legal entity providing interstate telecommunications 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.23 Entities with distinct articles of incorporation, articles of
21
See 47 CFR § 54.706(e) (“Any entity required to contribute to the federal universal service support mechanisms
shall retain, for at least five years from the date of the contribution, all records that may be required to demonstrate
to auditors that the contributions made were in compliance with the Commission's universal service rules”);
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).
Section § 54.711(a) of the Commission’s rules, 47 CFR § 54.711, also requires contributors to “maintain records and
documentation to justify information reported in the Telecommunications Reporting Worksheet, including the
methodology used to determine projections, for three years and shall provide such records and documentation to the
Commission or the Administrator upon request.”
22
Id.
23
See 47 CFR § 64.1195 (outlining the Commission’s registration requirements).
Instructions — Page 9
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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:24
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;25
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;
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;26
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.27
This certification should be filed with the Commission’s Data Collection Agent (see address in Table 3)
and must also include:
24
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 et al., CC Docket No. 96-45 et al.,
Further Notice of Proposed Rulemaking and Report and Order, 17 FCC Rcd 3752 (2002) (2002 First Contribution
Methodology Order and FNPRM).
25
The FCC Form 499 Filings for the consolidated filer must reflect all revenues in this general ledger.
26
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.
27
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 10
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
A list of the legal names of all the legal entities covered by the filing. See instructions to
Line 112.
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.
C.
HOW TO FILE
1.
NO FILING FEE
There is no fee to file this form.
2.
WHEN 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
CFR § 1.4(e)(1).
Table 2: Filing Schedule for One-Time Requirements
What to file
New telecommunications carriers and other
telecommunications providers must register with
the Commission when they begin to provide
service.28 Registration with the Commission
includes obtaining an FCC registration number
(“FRN”) from the Commission registration system
(“CORES”) and obtaining a Filer ID from USAC’s
E-File system.
When to file
Upon beginning to
provide service, but
no later than 30
days after
beginning to
provide service.
New carriers and VoIP providers (including
interconnected and non-interconnected) must
identify an agent for service of process within the
District of Columbia. Although alternate agents
may be included in the filing, a resident D.C. agent
must be designated.
28
Where to file
FCC (to obtain an FRN)
https://apps.fcc.gov/coresWeb/publicHome.do
USAC (to obtain a 499 Filer ID)
http://www.universalservice.org/cont/filers/obta
in-a-filer-id.aspx
Such information is provided at Page 2, Block 2
of the FCC Form 499-A.
Registration information includes information reported in Blocks 1 and 2 of the Telecommunications Reporting
Worksheet.
Instructions — Page 11
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
What to file
Filers must update their registration information,
including a DC Agent for Service of Process in
accordance with these instructions to the FCC
Form 499-A.
When to file
Within one week of
the contact
information
change.
Filers that cease providing telecommunications
must deactivate their Filer ID with USAC by
submitting a letter with termination date and
information on their successor entity to USAC.
Filers must also update their CORES ID
information with the Commission
Within 30 days of
the date that the
company ceased
providing service.
Where to file
Filers wishing to update Preparer information,
headquarter address, billing contact information,
or DC Agent for Service of Process, can submit
either an FCC Form 499-A or an FCC Form
499-Q or, for billing-related matters only, email
USAC’s billing department.29 Filers wishing to
update any other information must submit a
revised FCC Form 499-A. For more
information, see
http://www.universalservice.org/cont/filers/mak
ing-revisions.aspx.
FCC
https://apps.fcc.gov/coresWeb/publicHome.do
USAC
http://www.universalservice.org/cont/tools/merg
er.aspx
Table 3: Filing Schedule for Annual Reporting Requirements
What to file
When to
file
April 1
Completed FCC Form 499-A
Completed FCC Form 499-Q (universal service
contributors only)
Traffic studies relied on by providers to report interstate
revenues on FCC Form 499-Q
See section IV.C.5.h for format and content
requirements for traffic studies
Consolidated filer certification
February 1
May 1
August 1
November 1
February 1
May 1
August 1
November 1
April 1
See section III.B for format and content requirements for
consolidated filer certification
Where to file
Data Collection Agent
http://forms.universalservice.org
Data Collection Agent
c/o Universal Service Administrative Company
http://forms.universalservice.org
File one copy with:
Data Collection Agent
c/o Universal Service Administrative Company
[email protected]
Data Collection Agent
c/o Universal Service Administrative Company
[email protected]
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
29
Filers seeking to update limited DC agent information such as an address and/or telephone number change for
more than twenty registrations at one time may contact USAC and request permission to submit a summary Excelstyled document containing these changes. Generally, changing an agent requires submission of an FCC Form 499A with the accompanying signature of the filer.
Instructions — Page 12
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
send a bill to the billing contact person and billing address identified on Line 208 of the FCC Form 499A. See Table 4 for contribution bases used by the USF, TRS, NANPA and LNPA administrators to
determine contribution obligations.
3.
ELECTRONIC FILING
Filers capable of accessing the Internet are required to file this form electronically. For information on
filing electronically, go to http://www.usac.org/about/tools/e-file.aspx.
Filers may file the consolidated filer certifications, and traffic studies by submitting paper copies to:
Form 499 Data Collection Agent c/o USAC, 700 12th Street N.W., Suite 900, Washington, D.C.
20005.
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
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-of-period adjustments to
revenue data unless such adjustments would affect a reported amount by more than ten percent.
Filers must submit any revised Worksheet that would result in decreased contributions by
March 31 of the year after the original filing due date.30
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. Thus, it is the successor company’s responsibility to ensure that
the revenues for both companies for the previous calendar year are accounted for in their entirety.
30
See Federal-State Joint Board on Universal Service et al., CC Docket No. 96-45 et al., Order, 20 FCC Rcd 1012,
1013, para. 2 (Wireline Comp. Bur. 2004), pet. for recon. and applications for review pending.
Instructions — Page 13
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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.
o
E.
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.
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.31 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.32 Review by the Commission or USAC may cover any existing corporate records, not just those
specifically maintained for these purposes.33 Entities acquiring carrier operations through consolidation,
merger, etc., must maintain the records of the acquired entity.34
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.35 In addition, entities may be billed by the administrators for reasonable
costs, including interest and administrative costs that are caused by late, inaccurate, or untruthful
filing of the Worksheet or overdue contributions.36 Inaccurate or untruthful information contained
in the Worksheet may lead to prosecution under the criminal provisions of Title 18 of the United
States Code.37
G.
ROUNDING OF NUMBERS AND NEGATIVE NUMBERS
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,
31
See 47 CFR § 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.”).
32
See id.; 47 CFR § 54.711(a).
33
See 47 U.S.C. § 218.
34
See 47 CFR § 42.1.
35
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 CFR § 1.1910;
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 6540 (2004).
36
See 47 CFR § 54.713 (universal service); 47 CFR § 64.604(c)(5)(iii)(A) and (B) (TRS); see also 47 CFR §
52.17(b) (NANPA); 47 CFR § 52.32(c) (LNPA).
37
See 47 CFR § 54.711.
Instructions — Page 14
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
$2,270,000.00, $2,271,881.93, or $2.272 million. Enter $0 in any line for which the filer had no revenues
for the year.
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.
IV.
SPECIFIC INSTRUCTIONS
A.
BLOCK 1: FILER IDENTIFICATION INFORMATION
Block 1 of the Telecommunications Reporting Worksheet reports identification information.
Line 101
499 Filer ID
USAC assigns an FCC Form 499 Filer ID number once a company completes the online registration
process at https://efileweb.usac.org/ContributorRegistration/V2. This number is then used for the
company to file subsequent FCC Forms 499. Filer 499 ID numbers can be found at:
FCC Form 499 Filer Database (http://apps.fcc.gov/cgb/form499/499a.cfm)
Telecommunications Provider Locator (https://www.fcc.gov/encyclopedia/telecommunicationsprovider-locator)
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
Legal Name of Filer
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 III.B.
Line 103
IRS Employer Identification Number
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.
Do not use individual social security numbers for the federal EIN.
If a filer lacks an EIN (i.e. has no taxpayer identification number to provide other than an
individual social security number), it should contact USAC (see section II for contact
information) so that it can be assigned an alternative identification number.
Consolidated filers must provide the EIN of the holding company.
Line 104
Doing Business As Name
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
Telecommunications Activities of Filer
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
Affiliated Filers/ Holding Company Information
Instructions — Page 15
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Enter a common identifier for all affiliated filers (the “Affiliated Filers Name”). This is typically the
name of the filer’s holding company or controlling entity, if any. Amongst a large group of affiliates, this
may be the name of the predominant commonly owned or controlled entity. All reporting affiliates or
commonly owned entities should have the same Affiliated Filers Name and IRS employer identification
number appearing on Line 106.1 and 106.2 respectively. For those entities also required to file FCC
Form 477, use the same single name that is used in the FCC Form 477 to indicate common ownership or
control.
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.”38 For this purpose, the term ‘owns’ means “to own an equity interest (or the equivalent
thereof) of more than 10 percent.”39
If the filer has no affiliates, check the appropriate box on Line 106.
Line 107
FCC Registration Number
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
Management Company
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
Mailing Address of Corporate Headquarters
Enter the complete mailing address of the corporate headquarters of the filer.
Lines 110-111
Business Address/ Telephone Number for Customer Inquiries and
Complaints
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
Trade Names
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.
38
See 47 U.S.C. § 153(2).
39
Id.
Instructions — Page 16
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Consolidated filers should provide all names used by all telecommunications affiliates covered by
the filing.
The list must include the filer’s billing agents if those parties, rather than the filer, are identified
on customer bills.
The list 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 non-filer might exist and also to ensure that entities are not billed improperly for predecessor
companies that no longer exist.
If there is insufficient space to enter all names, contact USAC.
B.
BLOCK 2: CONTACT INFORMATION
Block 2 of the Telecommunications Reporting Worksheet reports contact information for regulatory and
billing purposes.
1.
Line 201
BLOCK 2-A: REGULATORY CONTACT INFORMATION
499 Filer ID
Enter the Filer 499 ID from Line 101.
Line 202
Legal Name of Filer
Enter the legal name of the filer from Line 102.
Line 203-206
Person Who Completed This Worksheet/ Contact Information
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
Corporate Office to Which Correspondence Should Be Sent
Enter the contact person name, office name, and mailing address of a corporate office to which
correspondence regarding this Worksheet should be sent. An email address is also required and will not
be publicly released. USAC does NOT send Worksheets to this address; all Worksheets must be filed
using USAC’s electronic filing system. 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
Billing Contact Information
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.
Line 208.1 — An FCC ITSP regulatory fee bill, if due, will be sent to the email address specified on Line
208.1. FCC inquiries regarding ITSP regulatory fees will also be sent to this email address. Carrier
questions regarding ITSP regulatory fee bills should be directed to the FCC Financial Operations Help
Desk, 877-480-3201.
Although a filer may or may not use the same contact information for Lines 207 and 208, it is the filer’s
responsibility to ensure that accurate information is provided on both lines. A filer will be responsible for
Instructions — Page 17
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
any late fees, interest or penalties incurred as a result of its failure to provide accurate contact information
on this form.
2.
BLOCK 2-B: AGENT FOR SERVICE OF PROCESS
Section 413 of the Act requires each common 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. The Commission has
also extended this requirement to interconnected and non-interconnected VoIP providers.40
Lines 209-218
Agent for Service of Process
Carriers, interconnected VoIP providers, and non-interconnected VoIP providers must enter the company
name, contact person 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, and 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 particular carrier, interconnected VoIP provider or noninterconnected 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 noninterconnected 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.
New carriers and VoIP providers (including interconnected and non-interconnected) must identify an
agent for service of process must register with the FCC within 30 days of providing service, and all
carriers or VoIP providers (including interconnected and non-interconnected) must notify USAC within
one week if the contact information changes for their D.C. Agent. See Table 2 for more information.
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
FCC Registration Information
40
47 U.S.C. § 413; see 47 CFR § 1.47(h) (interconnected VoIP providers); Contributions to the Telecommunications
Relay Services Fund, CG Docket No. 11-47, Report and Order, 26 FCC Rcd 14352, 14542, para. 21 (2011) (noninterconnected VoIP providers).
Instructions — Page 18
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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.
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
Jurisdictions in Which Filer Provided/ Will Provide Service
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.41 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
Year and Month that Filer First Provided/ Will Provide Service
Enter the year and month that the filer first provided telecommunications or interconnected VoIP service.
If not yet providing either type of 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-A: FILER REVENUE INFORMATION
Blocks 3 and 4-A of the Telecommunications Reporting Worksheet report revenue information for
calendar year 2016.
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 (generally, the rows on
Form 499-A), which includes allocating revenues from bundled services between their
telecommunications and non-telecommunications components. See Section IV.C.2.
Second, the filer must attribute telecommunications revenues derived from sales to contributing
resellers (Block 3 on Form 499-A) or from sales to end users (Block 4 on Form 499-A). See
Section IV.C.4.
41
Both parties to a collect call are “consumers.” 47 C.F.R § 64.708; see 47 C.F.R § 64.710(b)(1).
Instructions — Page 19
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Third, the filer must apportion its telecommunications revenues between the intrastate, interstate,
and international jurisdictions (generally, the columns on the FCC Form 499-A). See Section
IV.C.5.
1.
FILER IDENTIFICATION
Line 301
Line 401
499 Filer ID
Enter the Filer 499 ID from Line 101.
Line 302
Line 402
Legal Name of Filer
Enter the legal name of the filer from Line 102.
2.
GROSS BILLED REVENUES – GENERAL
Report gross billed revenues as directed.
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.
Gross billed revenues include:
Revenues from all sources, including non-regulated telecommunications offerings, information
services, and other non-telecommunications services.
Total revenues billed to customers during the filing period with no allowances for uncollectibles,
settlements, or out-of-period adjustments.
Gross billed 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.
Gross billed revenues do NOT include:
Deposits
Instructions — Page 20
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Amounts that cannot be billed to customers and may be distinct from booked revenues
Taxes and surcharges that are not recorded on the company books as revenues, but are instead
remitted to government bodies.
BUT 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.
Special cases:
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.
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.
Mergers and acquisitions: 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.42 Where an entity obtains, by any means whatsoever, the
telecommunications operations or customer base of a filer, and the acquired company does not
file its own FCC Form 499-A, 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.
International Services: For international services, gross billed revenues consist of gross revenues
billed by U.S. telecommunications providers with no allowances for settlement or settlement-like
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 foreignbound 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 43.62 reports that are
net of credits at the time the credits are issued.
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 CFR § 43.62 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 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 43.62 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.
42
See Section III.C.
Instructions — Page 21
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
3.
APPORTIONING REVENUES AMONG REPORTING CATEGORIES
a.
General Information
Good-faith estimates
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.
Column (a) required
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.
Block 3 vs. Block 4 revenues
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. See Section IV.C.4 for
additional information on reporting revenues from resellers.
In many cases, the line-item categories are duplicated in Block 3 and Block 4.
Intercarrier compensation and universal service support: The following categories of
revenues are not end-user revenue and are reported in Block 3. For these revenue items, the
filer is not required to retain Filer 499 ID information or verify that the customer is a reseller.
Category of Revenue
Report on
Per-minute switched access charges and
reciprocal compensation
Line 304
Revenues received from carriers as
payphone compensation for originating
toll calls
Line 306
Charges for physical collocation of
equipment pursuant to 47 U.S.C. §
251(c)(6)
Line 307
Revenues that filers receive as universal
service support from either states or the
federal government
Line 308
Revenues received from another U.S.
carrier for roaming service provided to
customers of that carrier
Line 309
Carriers required to use the USOA: 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
Instructions — Page 22
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
those received from universal service contributors and those received from end users and
other non-contributors.43
Certain international switched service revenues: 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.
All filers should report revenues based on the following descriptions.
b.
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.
Line 303 (Carrier’s carrier)
Line 404 (End user)
Monthly service, local calling including message and local toll
charges, connection charges, vertical features, and other local
exchange services
Lines 303 and 404 should include the basic local service revenues, except for:
local private line revenues (reported on Lines 305 and 406);
business data services revenues (reported on Lines 305 and 406);
revenues from providing mobile or cellular services (reported on lines 309, 409, and 410);
subscriber line charges levied under a tariff filed by the filer or placed on customer bills as a passthrough of underlying carrier subscriber line charges (reported on line 405).
Lines 303 and 404 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;
o
Revenues from federally tariffed LNP surcharges should be reported on Line 404, and
should be identified as interstate revenues.
connection charges;
charges for connecting with mobile service; and
local exchange revenue settlements.
Interconnected VoIP providers not reporting based on the safe harbor that bundle fixed local exchange
service with interstate toll services at a unitary price must determine the appropriate portion of revenues
43
See section IV.C.4.
Instructions — Page 23
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
to allocate to interstate and international toll service, in a manner that is consistent with their supporting
books of account and records.
Filers should break out Line 303/404 revenues as follows:
Carrier’s Carrier Revenue
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.
End-User Revenue
Line 404.1
Local service portion of revenues from local exchange service plans
(other than interconnected VoIP plans) that include interstate calling as
part of the flat monthly fee.
Line 404.2
Toll portion of revenues from local exchange service plans (other than
interconnected VoIP 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 local exchange services plans (other than interconnected
VoIP 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.44
Line 304
Per–minute charges for originating or terminating calls
This line includes:
o
44
Per–minute charges for originating or terminating calls, including charges related to originating
or terminating VoIP-PSTN traffic.45
Bundled offerings include those offered directly by the filer and those offered by the filer through an affiliate.
45
See Connect America Fund et al., WC Docket No. 10-90 et al., Report and Order and Further Notice of Proposed
Rulemaking, 26 FCC Rcd 17663, 18005-08, paras. 940-42 (2011) (USF/ICC Transformation Order), aff’d.,sub
nom. In re: FCC 11-161, 753 F.3d 1015 (10th Cir. 2014) (setting forth default intercarrier compensation rates for
VoIP-PSTN traffic); Connect America Fund et al., WC Docket No. 10-90 et al., Second Order on Reconsideration,
27 FCC Rcd 4648, 4659-4663, paras. 30-35 (2012) (the Commission allowed local exchange carriers (LECs) to
tariff default rates equal to their intrastate originating access rates for originating intrastate toll VoIP traffic until
June 30, 2014, after which time LECs are to tariff default rates for such traffic equal to their interstate originating
access rates).
Instructions — Page 24
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
o
Revenues to the local exchange carrier for messages between a cellular customer and another
station within the mobile service area.
o
Any other gross charges to other carriers for the origination or termination of toll or non-toll
traffic.
o
Direct trunk transport, port charges, mileage charges and rearrangement charges that are normally
treated as access charge revenues.46
Do not deduct or net payments to carriers for origination or termination of traffic on their networks.
This line does not include:
o
International settlement or settlement-like receipts or transiting fees from international toll
services.
Filers should break out Line 304 revenues as follows:
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 405
Tariffed subscriber line charges, Access Recovery Charges, and
PICC charges levied by a local exchange carrier on a no-PIC
customer
Line 405 should include charges to end users specified in access tariffs, such as tariffed subscriber line
charges (SLCs), Access Recovery Charges (ARCs),47 and Primary Interexchange Carrier Charges
(PICCs) levied by a local exchange carrier on customers that are not presubscribed to an interexchange
carrier (i.e., a no-PIC customer). Note that federal SLCs are separate from toll revenues.
Line 405 should not include charges to end users for business data services (which are reported on Line
406).
The Commission does not regulate how non-incumbent LECs recover the costs of the local loop, nor does
it require non-incumbents to assess a non-traffic sensitive charge for the costs of providing interstate or
interstate access service from their customers through a separately stated end user charge. To the extent
non-incumbent contributors choose to assess a separately stated charge for the interstate portion of fixed
local exchange service or interstate exchange access, they should report such revenues on Line 405 and
allocate those revenues to the interstate jurisdiction, for USF contribution reporting purposes, in a manner
that is consistent with their supporting books of account and records.48
46
47 CFR Part 69.
47
The Commission allowed incumbent LECs to assess an ARC on certain wireline telephone customers, a rule
adopted as part of comprehensive intercarrier compensation reform. See USF/ICC Transformation Order, 26 FCC
Rcd at 17956-17961, 17987-17994, paras. 847-853, 905-916. The ARC is tariffed separately from the SLC;
however, the Commission permitted carriers to combine the ARC and SLC as a single line item on a customer bill.
Id., 26 FCC Rcd at 17958, para. 852. For purposes of reporting revenues on Line 405, incumbent LECs should
include all revenues collected from ARCs.
48
For example, to the extent that a contributor’s tariff filing (or equivalent) indicates that a non-traffic sensitive
charge is for interstate access, then revenues for such charge (or a portion thereof) must be allocated to interstate
revenues for USF reporting purposes.
Instructions — Page 25
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Telecommunications providers that do not have SLC, ARC or PICC tariffs on file with the Commission
or with a state utility commission, that are not reselling such tariffed charges, or that do not have
separately stated charges for the interstate portion of fixed local exchange service or interstate exchange
access should report $0 on Line 405.
Line 305 (Carrier’s Carrier)
Line 406 (End User)
Local Private Line and Business Data Service
Line 406 should include:
o
Revenues from providing local services that involve dedicated circuits, private switching
arrangements, digital subscriber lines, and/or predefined transmission paths, including those
services that provide dedicated point-to-point transmission of data at certain guaranteed speeds and
service levels using high-capacity connections.
o
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.
o
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.
o
Revenue from broadband transmission service, including consumer broadband-only loop service,
voluntarily provided on a common carrier basis to providers of retail broadband Internet access.49
o
o
Filers should report on Line 406 revenues derived from the sale of special access service
on a common carrier basis to providers of retail broadband Internet access service.50
All other revenues from local private line service and business data service billed to end users
must be reported on Line 406.
Revenues for the provision of broadband transmission offered on a non-common-carrier basis to
providers of broadband Internet access should be reported on Line 418.51
Amounts reported on Line 305 should be divided between:
49
See Protecting and Promoting the Open Internet, Report and Order on Remand, Declaratory Ruling and Order,
GN Docket No. 14-28, 30 FCC Rcd 5601, 5836, para. 489 n.1472 (2015) (2015 Open Internet Order), aff’d sub
nom., United States Telecomms Ass’n v. FCC, 825 F.3rd 674 (D.C. Circ. 2016), pets. for rehearing pending.
Pursuant to the forbearance granted in the 2015 Open Internet Order, revenues for the provision of retail wireline
broadband Internet access services should be reported on Line 418. Id. at 5836, para. 489.
50
See Universal Contribution Methodology, Application for Review of Decision of the Wireline Competition Bureau
filed by Global Crossing Bandwidth, Inc., et al., WC Docket No. 06-122, Order, 27 FCC Rcd 13780, 13797, para.
39 n.109 (2012) (2012 Wholesaler-Reseller Clarification Order); Wireline Broadband Internet Access Services
Order, 20 FCC Rcd at 14915-16, paras. 112-113 & n.357; 2006 Contribution Methodology Reform Order, 21 FCC
Rcd at 7549, para. 62 n.206.
51
This includes rate-of-return carriers “who choose[] to detariff [their] wholesale consumer broadband-only loop
offering” and “would not have a contribution obligation for that service, similar to other carriers that previously
chose not to offer a separate tariffed broadband transmission service.” Connect America Fund; ETC Annual Reports
and Certifications; Developing a Unified Intercarrier Compensation Regime, WC Docket No. 10-90 et al., 31 FCC
Rcd 3087, 3159, para. 193 n.428 (2016) (citation omitted). See also Connect America Fund; ETC Annual Reports
and Certifications; Developing a Unified Intercarrier Compensation Regime, WC Docket No. 10-90 et al., 31 FCC
Rcd 6856, 6862, para 24 n.39 (WCB 2016) (clarifying that the broadband-only loop offering must “not only [be]
detariffed, but also offered on a private carriage basis.”).
Instructions — Page 26
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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.
Mixed-use private or WATS lines: If over ten percent of the traffic carried over a private or WATS line
is interstate, then the revenues and costs generated by the entire line are classified as interstate.52
Line 306 (Carrier’s Carrier)
Line 407 (End User)
Payphone Revenues
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 (Carrier’s Carrier)
Line 408 (End User)
Other Local Telecommunications Service Revenues
Include local telecommunications service revenues that reasonably would not be included with one of the
other fixed local service revenue categories. Report any revenues from offering switched capacity on
local area data networks such as ATM or frame relay networks.
Line 307 should include charges for physical collocation of equipment pursuant to 47 U.S.C. § 251(c)(6).
Line 308
Universal Service Support Amounts Received from Federal or State
Sources
Universal service support revenues should include:
All amounts that filers receive as universal service support from either states or the federal
government. Include amounts received as cash as well as amounts received as credit against
contribution obligations.
Do not include:
Any amounts charged to customers to recover universal service or similar contributions.
Charges or credits for subsidized services provided to schools, libraries, and rural health care
providers. Such charges are properly reported as end user revenue.
c.
Mobile service categories
Mobile services are wireless communications between mobile wireless equipment, such as cellular
phones and other points.
Line 309 (Carrier’s Carrier)
Line 409 and 410 (End User)
Mobile Services
Data reported on these lines should contain mobile service revenues, except:
52
Toll charges to mobile service customers
See Universal Service Order, 12 FCC Rcd at 9173, para. 778 (citing 47 CFR § 36.154(a)).
Instructions — Page 27
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
o
Itemized toll charges to mobile service customers should be included in Lines 413 or 414,
as appropriate.
Charges associated with customer premises equipment
Roaming charges for service provided by foreign carriers operating in foreign points. These
charges are not U.S. telecommunications revenues and therefore should be reported on Line 418.
Filers should break out Line 309/409/410 revenues as follows:
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.
Instructions — Page 28
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
d.
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.
For wireless providers, toll services are telecommunications services that enable customers to
communicate outside the customer’s plan-defined home calling area.53 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 plan-specific per month charge, assuming the subscriber does
not exceed the plan allotted minutes.54
Line 411
Prepaid Calling Cards
Include:
Revenues from prepaid calling cards provided either to customers, distributors, or to retail
establishments.
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.55
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 43.62 international traffic data reports.
Line 310 (Carrier’s carrier)
Line 413 (End User)
Operator and toll calls with alternative billing arrangements
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
All charges from toll or long distance directory assistance
53
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) (Separately Stated Toll
Order).
54
Id. at 1415, para. 7, n.28.
55
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) (AT&T Prepaid Calling Card Services Declaratory Ruling); 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, Order, 25 FCC Rcd 14533, 14538–39,
paras. 12–13 (Wireline Comp. Bur. 2010) (Network IP Order), petition for partial reconsideration denied, Request
for Review of a Decision of the Universal Service Administrator by Network Enhanced Telecom, LLP, WC Docket
No. 06-122, Order on Reconsideration, 26 FCC Rcd 6169 (Wireline Comp. Bur. 2011).
Instructions — Page 29
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Revenues from all calls placed from all coin and coinless, public and semi-public,
accommodation and prison telephones, except that:
o
Calls that are paid for via prepaid calling cards should be included on Line 411.
o
Calls paid for by coins deposited in the phone should be included on Line 407.
Line 412
International Calls that Originate and Terminate in Foreign
Points
International calls that traverse the United States but both originate and terminate in foreign points
(“transit” revenues) are excluded from the universal service contribution base.
Carrier’s carrier (reseller) transit revenues should be reported on Line 311.
End-user transit revenues should be segregated from other toll revenues by showing them on Line
412.
Telecommunications providers should not report international settlement revenues from traditional
settlement transiting traffic on the Worksheet.
Line 311 (Carrier’s carrier)
Line 414 (End User)
Ordinary Long Distance
Filers should report ordinary long distance revenues on these lines, including:
Revenues from most toll calls placed for a fee
Flat monthly charges billed to customers, such as account maintenance charges, PICC passthrough charges, and monthly minimums
Ordinary message telephone service (MTS), WATS, subscriber toll-free, 900, “WATS-like,” and
similar switched services
Separately stated toll revenue from wireline, wireless, and interconnected VoIP services.56
Do not include:
Revenues for the toll portion of flat rated local service (other than interconnected VoIP service),
regardless of whether this portion of revenue is reported by a local exchange carrier or by its toll
affiliate. Report such revenues on Line 404.2.
Revenue for the toll portion of flat rated interconnected VoIP local service. Report such revenues
on Line 404.4 or Line 404.5, as appropriate.
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 technologies other
than interconnected VoIP, including toll service that employs Internet
Protocol but that is not provided on an interconnected VoIP basis.57
56
See 2006 Contribution Methodology Reform Order, 21 FCC Rcd at 7534, para. 29.
57
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 30
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Line 414.2
Separately billed revenue for ordinary long distance provided to end
users using interconnected VoIP.
Line 312 (Carrier’s Carrier)
Line 415 (End User)
Long Distance Private Line Services
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.
Frame relay and similar services where the customer is provided a dedicated amount of capacity
between points in different basic service areas.
Revenues from the resale of business data 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 (Carrier’s carrier)
Line 416 (End User)
Satellite Services
Include:
Revenues from providing space segment service and earth station link-up capacity used for
providing telecommunications or telecommunications services via satellite.
Do not include:
Revenues derived from the lease of bare transponder capacity.
Line 314 (Carrier’s carrier)
Line 417 (End User)
All Other Long Distance Services
Include:
All other revenues from providing long distance communications services.
Toll teleconferencing.58
Switched data, frame relay and similar services where the customer is provided a toll network
service rather than dedicated capacity between two points.
58
Audio bridging service providers should report all audio bridging revenues as telecommunications revenues. See
Intercall Order, 23 FCC Rcd at 10734, 10739, paras. 8, 25 - 26.
Instructions — Page 31
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
e.
Line 403
Other revenue categories
Surcharges or other amounts on bills identified as recovering State
or Federal universal service contributions
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 support
mechanisms must be shown on Line 403 and should be identified as either interstate or
international revenues, as appropriate. 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.
Line 418
Other revenues that should not be reported in the contribution
bases
Non-interconnected VoIP revenues (TRS only)
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. Line 418.4 should include noninterconnected VoIP revenues, which are included in the TRS contribution base only.
Line 418 includes:
Information services.
o
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.
Revenues for the provision of broadband transmission offered on a non-common-carrier basis to
providers of broadband Internet access
Revenues for the provision of broadband Internet access
Published directory services
Billing and collection services
Inside wiring
Inside wiring maintenance insurance
Pole attachments
Open video systems (OVS)
Cable leased access
Cable service
Instructions — Page 32
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Direct broadcast satellite (DBS) service
Revenues from the sale, lease, installation, maintenance, or insurance of customer premises
equipment (CPE)
Revenues 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.
Late payment charges
Charges imposed by the filer for customer checks returned for non-payment
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 other revenues properly reported on line 418 except those reported
in Lines 418.1, 418.2, and 418.4, including broadband Internet access
service subject to forbearance and broadband transmission service
provided on a non-common carrier basis to a broadband Internet
access provider.
Line 418.4
Revenues from non-interconnected VoIP services sold to end users
that are not otherwise includable on Lines 403 to 417. Noninterconnected VoIP service is defined in Appendix B, under noninterconnected VoIP service provider.59
f.
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.
59
For TRS purposes, “providers of non-interconnected VoIP services that are offered with other (non-VoIP)
services that generate end-user revenues [are required] to allocate a portion of those end-user revenues to the noninterconnected VoIP service in two circumstances: (1) when those providers also offer the non-interconnected VoIP
service on a stand-alone basis for a fee; or (2) when those providers also offer the other (non-VoIP) services without
the non-interconnected VoIP service feature at a different (discounted) price.” See 2011 TRS Contributions Order,
26 FCC Rcd at 14538-39, para. 15. For example, a video gaming service may integrate chat functions that utilize
non-interconnected VoIP services, but use of such functions may not be readily identifiable or separable from the
gaming service components. Id. at 14538-41, paras. 15-17.
Instructions — Page 33
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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
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.60
Similarly, providers of non-interconnected VoIP services that are offered with end-user revenue
generating (non-VoIP) services may avail themselves of the bundled service safe harbors for allocating
revenue.61
g.
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.
60
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
Regulation of Prepaid Calling Card Services, WC Docket No. 05-68, Declaratory Ruling, Report and Order, 21
FCC Rcd 7290, 7298, para. 22 (2006) (Prepaid Calling Card Services Order), vacated in part, Qwest Servs. Corp.
v. FCC, 509 F.3d 531 (D.C. Cir. 2007).
61
See 2011 TRS Contributions Order, 26 FCC Rcd at 14538-41, paras. 15-17.
Instructions — Page 34
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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.
4.
ATTRIBUTING REVENUES FROM CONTRIBUTING RESELLERS
AND FROM END USERS
Filers must report revenues using two broad categories: (1) revenues reported in Block 3 (revenues from
contributing resellers, intercarrier compensation, and universal service support) and (2) revenues reported
in Block 4 (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.
Except as noted below, most categories of revenues require the filer to determine whether the customer
purchasing the telecommunications is a contributing reseller or instead an end user.62 Revenues from
services provided by underlying carriers to other entities that meet the definition of “reseller” (see below)
are referred to herein as “carrier’s carrier revenues” or “revenues from resellers.” Revenues from all
other sources consist primarily of revenues from services provided to end users, referred to here as “enduser revenues.” This latter category includes foreign and non-telecommunications revenues.
a.
Definition of “Reseller”
For purposes of completing Block 3, a “reseller” is a telecommunications carrier or telecommunications
provider that: (1) incorporates purchased telecommunications into its own offerings; and (2) can
reasonably be expected to contribute to federal universal service support mechanisms based on revenues
from those offerings.63 Specifically, a customer is a reseller if it incorporates purchased wholesale service
62
See 2012 Wholesaler-Reseller Clarification Order, 27 FCC Rcd at 13786-87, para. 12; Changes to the Board of
Directors of the National Exchange Carrier Association, Inc.; Federal-State Joint Board on Universal Service, CC
Docket Nos. 96-45, 97-21, Report and Order and Second Order on Reconsideration, 12 FCC Rcd 18400, 18507
(1997) (“For this purpose, a reseller is a telecommunications service provider that 1) incorporates purchased
telecommunications services into its own offerings and 2) can reasonably be expected to contribute to support
universal service based on revenues from those offerings”); Federal-State Joint Board on Universal Service;
Request for Review of Decision of the Universal Service Administrator by Global Crossing Bandwidth, Inc., CC
Docket No. 96-45, Order, 24 FCC Rcd 10824, 10825-26, para. 5 (Wireline Comp. Bur. 2009) (Global Crossing
Order).
63
2012 Wholesaler-Reseller Clarification Order, 27 FCC Rcd at 13781-82, para.3.
Instructions — Page 35
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
into an offering that is, at least in part, assessable telecommunications and can be reasonably expected to
contribute to the federal universal service support mechanisms for that portion of the offering.64
b.
Revenues from Entities Exempt from USF Contributions
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
contributing 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.
o
Underlying carriers must contribute to the universal service support mechanisms on the
basis of such revenues.
o
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.
c.
“Reasonable Expectation” Standard
Pursuant to the 2012 Wholesaler-Reseller Clarification Order, a filer may demonstrate that it has a
“reasonable expectation” that a customer contributes to federal universal service support mechanisms
based on revenues from the customer’s offerings by following the guidance in these instructions or by
submitting other reliable proof.65
Filers that comply with the procedures specified in this section of the instructions will be afforded a “safe
harbor”- i.e., that filer will be deemed to have demonstrated a reasonable expectation. If a wholesale
provider follows procedures that deviate in any way from the guidance in this section, the wholesale
provider will have to demonstrate a reasonable expectation via “other reliable proof.”66 USAC shall
evaluate the use of “other reliable proof” to demonstrate a “reasonable expectation” on a case-by-case
basis, based on the reasonableness of the utilized method or proof.67
64
Thus, for example, if a customer purchases a DSl line and incorporates that service into an offering of both
telephone service and broadband Internet access service, it may certify that it is a reseller for purposes of that
purchased service so long as it contributes on the assessable revenues from the telephone service. See id. at 13796,
para. 34 n.98.
65
2012 Wholesaler-Reseller Clarification Order, 27 FCC Rcd at 13794, para. 32, and 13801-02, paras. 51-52; see
Global Crossing Order, 24 FCC Rcd at 1028-29, para. 14.
66
See id. at 13801-02, paras. 51-52.
67
This requirement is further discussed in the 2012 Wholesaler-Reseller Clarification Order, 27 FCC Rcd at 138012, para. 52.
Instructions — Page 36
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Filers that do not comply with the safe harbor procedures or that do not otherwise meet the reasonable
expectation standard will be responsible for any additional universal service assessments that result if
their revenues must be reclassified as end user revenues.68
d.
Safe Harbor Procedures for Meeting the “Reasonable Expectation.”
Each filer should have documented procedures to ensure that it reports as “revenues from resellers” only
revenues from entities that meet the definition of reseller. The procedures must include, at a minimum,
the following information on resellers:
1. Filer 499 ID;
2. Legal name;
3. Legal address;
4. Name of a contact person;
5. Phone number of the contact person; and,
6. As described below, an annual certification by the reseller regarding its reseller status;
Filers shall provide this information to the Commission or the Administrator upon request.
e.
Certifications
Annual Certificates. A filer may demonstrate that it had and has a reasonable expectation that a particular
customer is a reseller with respect to purchased service(s) by providing a certificate signed each calendar
year by the customer that:
(1) specifies which services the customer is or is not purchasing for resale pursuant to the
certificate;69 and
(2) is consistent with the following sample language:
I certify under penalty of perjury that the company is purchasing service(s) for resale, at
least in part, and that the company is incorporating the purchased services into its own
offerings which are, at least in part, assessable U.S. telecommunications or
interconnected Voice over Internet Protocol services. I also certify under penalty of
perjury that the company either directly contributes or has a reasonable expectation that
68
If a wholesale provider’s customer (or another entity in the downstream chain of resellers) actually contributed to
the federal universal service support mechanisms for the relevant calendar year on offerings that incorporate
purchased wholesale services, the wholesale provider will not be obligated to contribute on revenues for the
wholesale services, even if the wholesale provider cannot demonstrate that it had a reasonable expectation that its
customer would contribute when it filed its FCC Form 499-A for the relevant calendar year. Id. at 13799, paras. 4344.
69
At the filer’s discretion, the filer may, for example, rely on certificates that specify any of the following: (1) that
all services purchased by the customer are or will be purchased for resale pursuant to the certificate (“entity-level
certification”); (2) that all services associated with a particular billing account, the account number for which the
customer shall specify, are or will be purchased for resale pursuant to the certificate (“account-level certification”);
(3) that individual services specified by the customer are or will be purchased for resale pursuant to certification
(“service-specific certification”); or (4) that all services except those specified either individually or as associated
with a particular billing account, the account number(s) for which the customer shall specify, are or will be
purchased for resale pursuant to the certificate. A customer may certify that additional services will be purchased
for resale pursuant to the certificate if the customer (or another entity in the downstream chain of resellers) will
contribute to the federal universal service support mechanisms on revenues attributed to such services for the
relevant calendar year.
Instructions — Page 37
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
another entity in the downstream chain of resellers directly contributes to the federal
universal service support mechanisms on the assessable portion of revenues from
offerings that incorporate the purchased services.70
Services Purchased After Date of Annual Certificate. A filer may sell additional service(s) to a customer
after the date that the annual certificate is signed. If the annual certificate does not cover those additional
services, the filer may demonstrate a reasonable expectation that a customer is a reseller with respect to a
service purchased after the date of the annual certificate signed by the customer by relying on either of
these received prior to the filing of the applicable FCC Form 499-A:
(1) a verifiable notification from the customer that the customer is purchasing the service
for resale consistent with the valid, previously signed annual certificate, or
(2) a subsequent certificate covering the purchased service signed by the customer.
5.
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.
a.
Definitions
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.
b.
General Requirements
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.
o
Total revenues entered in column (a) include revenues billed for intrastate service even
though intrastate revenues are not reported separately on the FCC Form 499-A.
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.
o
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. 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.
70
In some instances, reselling carriers are themselves selling the underlying service to another (non-contributing)
reseller, which then sells the same service to another (non-contributing) reseller, and so on until the service is
ultimately sold to an entity that is a contributing “reseller.” In these instances, an underlying carrier also may
include as carrier’s carrier revenue any revenues received from service ultimately provided to entities that meet the
definition of “reseller” for purposes of the FCC Form 499-A.
Instructions — Page 38
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
o
A reporting entity may not submit a good-faith estimate lower than one percent unless the
correct figure should be $0.
o
Good-faith estimates must be based on information that is current for the filing period.
o
Information supporting good-faith estimates must be made available to either the FCC or to
the administrators upon request.
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 per-minute
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.
c.
Services Offered Under Interstate Tariffs
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.
d.
Flat-rate Unbundled Network Access Elements
In general, flat-rated unbundled network access elements should be classified according to the regulatory
agency that has primary jurisdiction over the contracts.
e.
Mixed-Use Private or WATS Lines
If over ten percent of the traffic carried over a private or WATS line is interstate, then the revenues and
costs generated by the entire line are classified as interstate.71
f.
Bundled Local and Toll Services
Many carriers and other providers of telecommunications now offer packages that bundle fixed local
exchange service with interstate toll service (i.e., voice long distance) for a single price.
o
Revenues for the whole bundle, except for tariffed subscriber line, ARC and PICC charges,
should be reported on Line 404, as described more fully above.
o
The portion of revenues associated with interstate and international toll services must be
identified in columns (d) and (e), respectively.72
o
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.
g.
Safe Harbors
Wireless telecommunications providers, interconnected VoIP providers, and non-interconnected VoIP
providers that choose to avail themselves of 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.
Wireless Safe Harbor: The FCC provides the following safe harbor percentages of interstate revenues
associated with Line 309, Line 409, and Line 410:73
71
See Universal Service Order, 12 FCC Rcd at 9173, para. 778 (citing 47 CFR § 36.154(a)).
72
See Separately Stated Toll Order, 23 FCC Rcd at 1414, para. 5 (defining “toll service”).
Instructions — Page 39
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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.
Interconnected and Non-Interconnected VoIP Safe Harbor: The FCC provides the following safe harbor
percentage of interstate revenues associated with Line 303.2, Line 404.4, Line 404.5, Line 414.2, and
Line 418.4:
64.9% of interconnected VoIP and non-interconnected VoIP telecommunications revenues74
These safe harbor percentages may not be applied to universal service pass-through
charges or other fixed local service revenues.
Single Election for Affiliated Entities: All affiliated wireless telecommunications providers and VoIP
providers (including interconnected and non-interconnected) 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.75
o
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.
o
The same wireless telecommunications provider and all affiliates, however, could use the safe
harbor for paging services.
Same Methodology for the FCC Form 499-A and the FCC Form 499-Q: Filers should use the same
methodology (traffic study or safe harbor) to report interstate and international jurisdictions on the FCC
Form 499-A as used on the FCC Form 499-Qs to forecast revenue in each quarter of the applicable
calendar year.
o
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
(Continued from previous page)
73
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 et al., CC Docket No. 96-45 et al., Report and Order and Second
Further Notice of Proposed Rulemaking, 17 FCC Rcd 24952 (2002) (2002 Second Contribution Methodology Order
and FNPRM); 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, paras. 11-15
(1998).
74
2006 Contribution Methodology Reform Order, 21 FCC Rcd at 7545, para. 53.
75
See Federal-State Joint Board on Universal Service et al., CC Docket No. 96-45 et al., Order and Order on
Reconsideration, 18 FCC Rcd 1421, 1424-25, para. 6 (2003) (“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 CFR § 1.2110(c)(5).
Instructions — Page 40
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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.
Filers Not Required to File an FCC Form 499-Q: For filers who were not required to file the FCC Form
499-Q, the interstate and international jurisdictions reported on the FCC Form 499-A must be based on
information that is current for the filing period.
h.
Traffic Studies
Wireless telecommunications providers, interconnected VoIP providers, and non-interconnected VoIP
providers may rely on traffic studies if they are unable to determine their actual interstate and
international revenues.76
o
In developing their traffic studies, such providers may rely on statistical sampling to estimate the
proportion of minutes that are interstate and international.
o
Any revenues associated with charges on customer bills that are identified as interstate or
international must effectively be accounted for (e.g., through proper weighting in a traffic study)
as 100 percent interstate or international when reporting revenues.77
o
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.
o
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.
o
Mobile telecommunications providers, interconnected VoIP providers and non-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.
o
In addition, filers that rely on traffic studies must submit those studies to USAC (see Table 3 for
filing instructions – including address for filing traffic studies, and filing deadlines). To enable
USAC to match traffic studies filed by contributors with their FCC Form 499 filings, include the
following identifying information at the top of each page of the traffic study: Filer ID; Company
Name; Affiliated Filers Name (where applicable).
D.
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
76
See 2006 Contribution Methodology Reform Order, 21 FCC Rcd at 7534–36, 7547, paras. 29–33, 57; 2011 TRS
Contributions Order, 26 FCC Rcd at 14544, para. 25.
77
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.
Instructions — Page 41
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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
Gross Universal Service Contribution Base Amounts
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 IV.E (Line
511 instructions).
Line 421
Uncollectible revenue/ bad debt associated with Line 419 (Gross
Billed Revenues)
Show the uncollectible revenue/bad debt expense associated with gross billed revenues amounts reported
on Line 419.
For those using billed revenues, this line may include redeemed credits.
Reported uncollectible amounts should:
o
Be the amount reported as bad debt expense in the filer’s income statement for the year.
o
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.
o
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.
Uncollectibles may not include any amounts associated with unbillable revenues.78
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.
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.
Line 422
Uncollectible revenue/ bad debt associated with Line 420 (Universal
Service Contribution Base Amounts)
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.
78
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.
See 2002 Second Contribution Methodology Order and FNPRM, 17 FCC Rcd at 24970 n.95.
Instructions — Page 42
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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.
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.
Line 423
Net universal service contribution base revenues
Net universal service contribution base revenues should equal the amounts reported on Line 420 minus
the amounts reported on Line 422.
E.
BLOCK 5: ADDITIONAL REVENUE BREAKOUTS FOR NON-USF
MECHANISMS
Line 501
Filer 499 ID
Enter the Filer 499 ID from Line 101.
Line 502
Legal Name of Filer
Enter the legal name of the filer from Line 102.
Line 503-510
Percentages of Telecommunications Revenues by LNPA Region
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.
Customer billing addresses may be used to calculate or estimate this percentage.
The percentages in column (a), representing Block 3 revenues billed in each region of the
country, 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), representing Block 4 telecommunications service revenues billed
in each region of the country (excluding non-telecommunications revenues reported on Line 418)
should add to 100% unless the filer did not provide any telecommunications services to end users
or non-contributing carriers.
o
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.
Instructions — Page 43
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
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
Revenues from Resellers that Do Not Contribute to Universal
Service Support Mechanisms and Are Included in Block 4
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
Gross TRS Contribution Base Amounts
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
Uncollectible Revenue/ Bad Debt Expense Associated with TRS
Contribution Base Amounts
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
Net TRS contribution base revenues should equal the amounts reported on Line 512 less the amounts
reported on Line 513.
Instructions — Page 44
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
F.
BLOCK 6: CERTIFICATION
Line 601
Filer 499 ID
Copy the Filer 499 ID from Line 101.
Line 602
Legal Name of Filer
Copy the legal name of the filer from Line 102.
Line 603
Certifications – Exemptions from Contribution Requirement(s)
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 III.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 an
FCC Form 499.
Line 604
Regulatory Fee Exemptions
In this line, filers indicate whether they are exempt from FCC regulatory fees or the filer is an “exempt
telecommunications company.”79
A state or local governmental entity is any state, possession, city, county, town, village, municipal
corporation, or similar political organization.80
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.81
These organizations typically qualify for non-profit status under sections 501(c)(3) or 501(c)(12).
79
47 CFR § 1.1162(c). The FCC will presume that otherwise exempt carriers prefer to pay FCC regulatory fees
unless they check this box.
80
47 CFR § 1.1162(b).
81
47 CFR § 1.1162(c).
Instructions — Page 45
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Note that such entities are not exempt from universal service, TRS, LNP, or NANPA contributions unless
they qualify under some other exemption.
Line 605
Request for Nondisclosure of Revenue Information
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.82
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 2-B 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.
Line 606-611
Officer Certification
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 III.B 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.
Capable filers must enter data, and verify, submit, and certify FCC Forms 499-A and 499-Q online via
USAC’s web-based data entry system, E-File.
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.usac.org/about/tools/e-file.aspx/ 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.83
82
47 CFR § 0.459; see 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).
83
See 18 U.S.C. § 1001.
Instructions — Page 46
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Line 612
Type of Filing
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 section III.C for information on the obligation to file revisions.
V.
CALCULATION OF CONTRIBUTIONS
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 4.
Table 4: Contribution Bases
Support Mechanism
Funding Basis
Universal service
less
TRS
Line 423(d) + Line 423(e)*
revenues corresponding to universal service
contributions**
Line 514(b)
(Filers with interstate or international end-user
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 CFR § 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). See also FCC, Contribution Factor & Quarterly Filings - Universal Service Fund (USF)
Management Support, https://www.fcc.gov/encyclopedia/contribution-factor-quarterly-filings-universalservice-fund-usf-management-support.
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.
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.
Instructions — Page 47
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
VI.
The FCC Form 499-Q provides instructions for projecting revenues, and for removing
uncollectible amounts from billed revenue projections.
The amounts filed on the FCC Form 499-A are used to review and true-up FCC Form 499-Q
filings and associated contributions.
ADDITIONAL INFORMATION
A.
REMINDERS
File the FCC Form 499-A online at http://forms.universalservice.org.
Contributors are required to maintain records and documentation to justify information
reported on the Telecommunications Reporting Worksheet for five years. See section III.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 III.B. Each
affiliate or subsidiary must show the same Affiliated Filers 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 III.C.
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 III.C.
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 https://www.fcc.gov/encyclopedia/informationfirms-providing-telecommunications-services-0.
B.
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 CFR § 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 CFR § 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 CFR §§ 54.706, 54.711, 54.713. Section 64.604 requires that every common
carrier, interconnected VoIP provider, and non-interconnected VoIP provider contribute to the TRS Fund
on the basis of its relative share of interstate end-user revenues that are subject to contributions based on
Instructions — Page 48
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
information provided in this Worksheet. 47 CFR §§ 64.601(b), 64.604(c)(5)(iii)(A) and (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 CFR § 64.1195(a).
This collection of information stems from the Commission’s authority under sections 151(i), 225, 251,
254, 258, and 715 of the Communications Act of 1934, as amended, 47 U.S.C. §§ 151(i), 225, 251, 254,
258, 616. 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, you may 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 CFR §§ 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 49
2017 Instructions to the Telecommunications Reporting Worksheet, FCC Form 499-A
Appendix A
How to determine if a filer meets the universal service de minimis standard for 2016
(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) 2017 de minimis estimation factor
0.164 ***
(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(2).
**
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 CFR § 54.706(c).
***
The estimation factor is based on a contribution factor of .196, which is higher than the contribution
factor announced for any quarter of 2016, and a corresponding circularity factor of 0.164070.
Actual contribution and circularity factors for 2017 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 as detailed in
Sections II.A.2 or II.A.3.
Instructions — Page 50
2017Instructions 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 CFR § 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
Instructions — Page 51
2017Instructions to the Telecommunications Reporting Worksheet, Form 499-A
service by setting the price of the card, assigning personal identification numbers (PINs) and controlling
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.84
84
See AT&T IP-in-the-Middle Order, 19 FCC Rcd 7457.
Instructions — Page 52
2017 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2016 Revenues)
APPROVED BY OMB
3060-0855
>>> Please read instructions before completing.<<<
Annual Filing -- due April 1, 2017
Block 1: Contributor Identification Information
102
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.]
Legal name of filer
103
104
IRS employer identification number
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.]
101
[Enter 9 digit number]
Audio Bridging (teleconferencing) Provider
CAP/CLEC
Cellular/PCS/SMR (wireless telephony inc. by resale)
Coaxial Cable
Incumbent LEC
Interconnected VoIP
Interexchange Carrier (IXC)
Local Reseller
Non-Interconnected VoIP
Operator Service Provider
Paging & Messaging
Payphone Service Provider
Prepaid Card
Private Service Provider
Satellite Service Provider
Shared-Tenant Service Provider / Building LEC
SMR (dispatch)
Toll Reseller
Wireless Data
Other Local
Other Toll
Other Mobile
106.1
If Other Local, Other Mobile or Other Toll is checked
describe carrier type / services provided:
Affiliated Filers Name/Holding Company Name (All affiliated companies must show the same name on this line.)
Check if filer has no affiliates
106.2
Affiliated Filers Name/Holding Company Name 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
Management company [if filer is managed by another entity]
109
Complete mailing address of reporting entity corporate headquarters
110
Complete business address for customer inquiries and complaints
check if same address as Line 109
111
112
Street1
Street2
Street3
City
Street1
Street2
Street3
City
State
State
Telephone number for customer complaints and inquiries [Toll-free number if available]
( )
List all trade names used in the past 3 years in providing telecommunications. Include all names by which you are known by customers.
a
b
c
d
e
f
Zip (postal code)
Country
Zip (postal code)
-
Country
ext -
g
h
i
j
k
l
Use additional sheets if necessary. Each filer must provide all names used for telecommunications activities
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 / January 2017
2017 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2016 Revenues)
Page 2
Block 2-A: Regulatory Contact Information
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
Contact person name, office name, and mailing address of a
corporate office to which correspondence regarding this
Telecommunications Reporting Worksheet should be sent.
201
202
203
204
205
206
207
check if same name as Line 203
check if same address as Line 109
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.]
208
check if name and address same as Line 207
208.1
Email address pertaining to ITSP regulatory fee issues
Block 2-B: Agent for Service of Process
209
210
211
212
213
D.C. Agent for Service of Process
Telephone number of D.C. agent
Fax number of D.C. agent
Email of D.C. agent
Complete business address of D.C. agent
for hand service of documents
214
215
216
217
218
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
Complete business address of local/alternate agent
for hand service of documents
First
MI
(
(
)
)
-
Last
ext -
Office
Attn: First name
MI
Last
Email not for public release
Phone (
) extFax ( )
- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - Street1
Street2
Street3
City
State
Zip (postal code)
Country
Company
Attn: First name
MI
Last
Email not for public release
Phone (
) extFax ( )
- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - Street1
Street2
Street3
City
State
Zip (postal code)
Country
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
Company
Attn: First name
MI
Last
(
)
ext (
)
Street1
Street2
Street3
City
Company
State
(
(
)
)
DC
-
Zip
Attn: First name
ext -
MI
Last
Street1
Street2
City
State
Zip (postal code)
Country
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 / January 2017
2017 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2016 Revenues)
219
220
221
222
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
check if same as Line 109
223
224
Second ranking company officer, such as Chairman
(Must be someone other than the individual listed on Line 221)
Business address of individual named on Line 223
check if same as Line 109
225
226
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
Page 3
Filers must refile Blocks 1, 2 and 6
if there are any changes in this section. See Instructions.
Block 2-C: FCC Registration and Contact Information
First
Street1
Street2
Street3
City
First
Street1
Street2
Street3
City
First
MI
Last
State
Zip (postal code)
MI
Last
Country
State
Zip (postal code)
MI
Last
Country
Street1
Street2
Street3
City
State
Zip (postal code)
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.
check if same as Line 109
227
228
Country
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
Check if prior to 1/1/1999, otherwise:
Year and month filer first provided (or expects to provide) telecommunications in the U.S.
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 / January 2017
2017 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2016 Revenues)
Page 4
Block 3: Carrier’s Carrier Revenue Information
Filer 499 ID [from Line 101]
301
Legal name of filer [from Line 102]
302
Report billed revenues for January 1 through December 31, 2016.
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.
Total
Revenues
(a)
If breakouts are not book
amounts, enter whole
percentage estimates
Interstate
International
(b)
(c)
Breakouts
Interstate
Revenues
International
Revenues
(d)
(e)
Revenues from Services Provided for Resale as Telecommunications
by Other Contributors to Federal Universal Service Support Mechanisms
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)
Provided under other arrangements
303.2
Per-minute charges for originating or terminating calls
Provided under state or federal access tariff
304.1
Provided as unbundled network elements or other contract arrangement
304.2
Local private line & business data service
Provided to other contributors for resale as telecommunications
305.1
Provided to other contributors for resale as interconnected VoIP
305.2
Payphone compensation from toll carriers
306
Other local telecommunications service revenues
307
Universal service support revenues received from Federal or state sources
308
Mobile services (i.e., wireless telephony, paging, messaging, and other mobile services)
Monthly, activation, and message charges except toll
309
Toll services
Operator and toll calls with alternative billing arrangements (credit card, collect,
310
international call-back, etc.)
Ordinary long distance(direct-dialed MTS, customer toll-free (800/888
311
etc.) service, “10-10” calls, associated monthly account maintenance,
PICC pass-through, and other switched services not reported above)
Long distance private line services
312
Satellite services
313
All other long distance services
314
315
Total revenues from resale [Lines 303 through 314]
See section III.C.2 of the instructions for the requirements applicable to revenue reported on this page. These records must be made available to the administrator or the FCC
upon request.
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 / January 2017
2017 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2016 Revenues)
Page 5
Block 4-A: End-User and Non-Telecommunications Revenue Information
Filer 499 ID [from Line 101]
401
Legal name of filer [from Line 102]
402
Report billed revenues for January 1 through December 31, 2016.
Do not report any negative numbers. Dollar amounts may be rounded to
the nearest thousand dollars. However, report all amounts as whole dollars.
Total
Revenues
See instructions regarding percent interstate and international.
If breakouts are not book
amounts, enter whole
percentage estimates
Interstate
International
(b)
(c)
Breakouts
Interstate
Revenues
International
Revenues
(d)
(e)
(a)
Revenues from All Other Sources (end-user, telecom. & non-telecom.)
Surcharges or other amounts on bills identified as recovering
403
State or Federal universal service contributions
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
Provided at a flat rate including interstate toll service – local portion
404.1
Provided at a flat rate including interstate toll service – toll portion
404.2
Provided without interstate toll included (see instructions)
404.3
Interconnected VoIP
Offered in conjunction with a broadband connection
404.4
Offered independent of a broadband connection
404.5
Tariffed subscriber line charges, Access Recovery Charges, and PICC charges
405
levied by a local exchange carrier on a no-PIC customer
Local private line & business data service [Includes the transmission
406
portion of wireline broadband Internet access provided on a common
carrier basis.]
Payphone coin revenues (local and long distance)
407
Other local telecommunications service revenues
408
Mobile services (i.e., wireless telephony, paging, messaging, and other mobile services)
Monthly and activation charges
409
Message charges including roaming and air-time charges for toll
410
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
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http://forms.universalservice.org
FCC Form 499-A / January 2017
2017 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2016 Revenues)
Page 6
Block 4-A: Continued
Total
Revenues
If breakouts are not book
amounts, enter whole
percentage estimates
Interstate
International
(b)
(c)
Breakouts
Interstate
Revenues
International
Revenues
(d)
(e)
(a)
Toll services
Prepaid calling card (including card sales to customers)
411
and non-carrier distributors) reported at face value of cards
International calls that both originate and terminate in foreign points
412
Operator and toll calls with alternative billing arrangements (credit
413
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)
All, other than interconnected VoIP, including, but not limited to,
414.1
itemized toll on wireline and wireless bills
All interconnected VoIP long distance, including, but not limited to,
414.2
itemized toll
Long distance private line services
415
Satellite services
416
All other long distance services
417
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)
bundled with circuit switched local exchange service
418.1
bundled with interconnected VoIP local exchange service
418.2
Other
418.3
418.4
0%
100%
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 minus 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 / January 2017
2017 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2016 Revenues)
Page 7
Block 5: Additional Revenue Breakouts
Filer 499 ID [from Line 101]
501
Legal name of filer [from Line 102]
502
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.
Block 3
Carrier’s Carrier
(a)
507
508
509
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
510
Total:
511
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.)
503
504
505
506
Southeast:
[Percentages must add to 0 or 100.]
Block 4
End-User Telecom
(b)
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
(a)
(b)
Total Revenues
Interstate and International
Revenues from resellers that do not contribute to Universal Service
512
513
514
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 / January 2017
2017 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting 2016 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
Universal Service
I certify that the filer is exempt from contributing to:
TRS
NANPA
LNP Administration
Provide explanation below:
________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________
604
Please indicate whether the filer is
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.
State or Local Government Entity
I.R.C. § 501 or State Tax Exempt (see instructions)
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 IIIB of the instructions.
606
Signature
607
608
609
610
611
612
Printed name of officer
Position with reporting entity
Business telephone number of officer
Email of officer not for public release
Date
Check those that apply
Original April 1 filing for year
______________________________________________________________________________
First
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. File this form online: http://www.usac.org/about/tools/e-file.aspx
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 UNITEDSTATES CODE, 18 U.S.C. § 1001
Save time, avoid problems – file electronically at
http://forms.universalservice.org
FCC Form 499-A / January 2017
| File Type | application/pdf |
| File Modified | 2017-08-03 |
| File Created | 2017-02-24 |