Pro Forma Financial Projection Form

Infrastructure Investment and Jobs Act - Application for Broadband Grant Programs

NTIA IIJA Pro Forma Financial Projection Form.xlsx

NTIA IIJA Middle Mile Grant Program Application Forms

OMB: 0660-0046

Document [xlsx]
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Income Statement


OMB Control No. 0660-XXX Expiration Date: TBD


















Forecast Period

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8
Revenues
















Network Services Revenues:







Wholesale Lit Capacity $- $- $- $- $- $- $- $-
Wholesale Transit (Paid Peering) $- $- $- $- $- $- $- $-
Wholesale Data Services (Other) $- $- $- $- $- $- $- $-
Retail Lit Capacity $- $- $- $- $- $- $- $-
Retail Transit (Paid Peering) $- $- $- $- $- $- $- $-
Retail Data Services (Other) $- $- $- $- $- $- $- $-
Dark Fiber $- $- $- $- $- $- $- $-
Colocation $- $- $- $- $- $- $- $-
Installation Revenues $- $- $- $- $- $- $- $-
Other Operating Revenues $- $- $- $- $- $- $- $-
Other Revenues $- $- $- $- $- $- $- $-
Uncollectible Revenues $- $- $- $- $- $- $- $-









Total Revenues $- $- $- $- $- $- $- $-









Expenses
















MMG Total Project Costs from SF-424 $- $- $- $- $- $- $- $-
Spares $- $- $- $- $- $- $- $-
Backhaul $- $- $- $- $- $- $- $-
Network Maintenance/Monitoring $- $- $- $- $- $- $- $-
Utilities $- $- $- $- $- $- $- $-
Leasing $- $- $- $- $- $- $- $-
Sales/Marketing $- $- $- $- $- $- $- $-
Customer Care $- $- $- $- $- $- $- $-
Billing $- $- $- $- $- $- $- $-
Corporate G&A $- $- $- $- $- $- $- $-
Other Operating Expense $- $- $- $- $- $- $- $-









Total $- $- $- $- $- $- $- $-









EBITDA $- $- $- $- $- $- $- $-

$- $- $- $- $- $- $- $-
Depreciation $- $- $- $- $- $- $- $-
Amortization $- $- $- $- $- $- $- $-









Earnings Before Interest and Taxes $- $- $- $- $- $- $- $-









Interest Expense - New Debt $- $- $- $- $- $- $- $-
Interest Expense - Existing Debt $- $- $- $- $- $- $- $-
Interest Expense - Other $- $- $- $- $- $- $- $-









Income Before Taxes $- $- $- $- $- $- $- $-









Property Tax $- $- $- $- $- $- $- $-
Income Taxes $- $- $- $- $- $- $- $-









Net Income $- $- $- $- $- $- $- $-













































Agency Disclosure Notice: This information collection is authorized by [OMB control #0660-XXXX]. Public reporting burden for this collection of information is estimated to average two (2) hours or 120 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to U.S. Department of Commerce, (National Telecommunications and Information Administration, 1401 Constitution Ave. NW, Washington, DC 20230). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
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