Note: This crosswalk index has One-to-One, One-to-Many, or Many-to-One relationships |
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Excel Tab |
Section of Instructions |
Pages |
A. General Information |
IV. Required Information, A General Information |
14 - 19 |
B. Overview Information |
IV. Required Information, B Overview Information |
19 - 20 |
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C1-C2. Company-Wide Information |
IV. Required Information, C1 Overall Financial Information |
20 - 22 |
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IV. Required Information, C2 Service-Specific Financial Information |
22 - 32 |
C3. Commissions and Revenue Sharing |
IV. Required Information, C3 Other Company-Wide Information, a. Site Commissions, d., e. |
32 - 35; 38 - 45 |
C3. Safety & Security Measures |
IV. Required Information, C3 Other Company-Wide Information, b., c. |
35 - 38 |
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D1. Facility Audio IPCS Costs |
IV. Required Information, D1 Facility-Specific Financial Information, a., b., c. |
45 - 49 |
D1. Facility Video IPCS Costs |
IV. Required Information, D1 Facility-Specific Financial Information, a., b., c. |
45 - 49 |
D1. Facility Demand and Revenue |
IV. Required Information, D1 Facility-Specific Financial Information, d. Facility-Specific Demand and Revenue Data |
49 - 52 |
D2.a No excel inputs required* |
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D2.b Facility-Specific Site Comm |
IV. Required Information, D2 Other Facility-Specific Information, b. Site Commissions |
52 - 58 |
D2.c. Fac-Spec S&S - Audio IPCS |
IV. Required Information, D2 Other Facility-Specific Information, c. Costs of Providers’ Safety and Security Measures |
58 - 59 |
D2.c. Fac-Spec S&S - Video IPCS |
IV. Required Information, D2 Other Facility-Specific Information, c. Costs of Providers’ Safety and Security Measures |
58 - 59 |
D2.d. Facilities' S&S Costs |
IV. Required Information, D2 Other Facility-Specific Information, d. Costs of Facilities’ Safety and Security Measures |
59 - 60 |
D2.e. Facility-Spec Ancillary |
IV. Required Information, D2 Other Facility-Specific Information, e. Ancillary Services Information |
60 - 63 |
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FCC Notice |
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* There is no tab D2a tab because the Word instructions under the D2a heading relate to the general information reported at the top of the D1. Facility Audio IPCS and D1. Facility Video IPCS tabs. |
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Workbook Structure |
Do not directly input data into this tab. |
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Most of the tabs in this workbook are data input tabs (12). These tabs have a few summation calculations which are highlighted (color coded yellow, green). |
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Summations from 2 input tabs ('Commission and Revenue Sharing' and 'Company-Wide Information') flow into the 'B. Overview Information' tab. |
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Summations from all tabs flow into this 'Color Coding & Checks' tab. |
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Cell Color Coding |
Interpretation |
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Gray |
Informational - Field names, row names, fillers. Do not enter data. |
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No color |
Numeric value - Enter only positive numbers or zero, with exceptions at the *. |
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No color |
Dropdown - Make a selection from a dropdown list, e.g., tax section of Company-Wide selections allows choice of "C" or "PTE". |
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No color |
N/A populated by FCC - Not Available for data entry means leave as is, do not enter data. |
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Yellow |
Formula - Do not change, delete or overwrite any FCC formulas with values, including those not highlighted. Note: Only a few examples are color coded in this workbook - not all instances. |
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Green |
Formulas that check for consistency - This tab checks the formula values in one tab against the corresponding formula values on another tab.** |
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* If the Company’s account balance for an asset, contra asset, liability, contra liability, revenue, contra revenue, expense, or contra expense account is the opposite of its expected debit or credit balance, report that balance as a negative number on the Excel template. For example, the expected account balance for accumulated deferred income taxes is a credit balance, representing a tax debt that will need to be paid in the future. If this is the case, report a positive number for accumulated deferred income taxes. If, instead, the account balance for the accumulated deferred income taxes is a debit balance, representing an over-payment or advance payment of income taxes, report that balance as a negative number. |
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** e.g., Sum of values for facilities = Company-wide value. See examples below. |
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Formula Checks |
The following checks will improve inter-tab consistency. |
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If the difference (or percent difference) in formula values from 2 tabs is low, then there is inter-tab consistency (closeness). |
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The provider should perform all similar checks. See examples below. |
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Review and revise the reported data to eliminate any inconsistencies among the tabs or explain any inconsistences in the Word template. |
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EXAMPLES: |
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Concept / Tabs |
Cells |
Values |
Calculations |
Notes |
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Total Site Commissions |
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B. Overview Information |
B26 |
0 |
L1 = L3 |
Overview tab references Commission and Rev Sharing tab |
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C1-C2. Company-Wide Information |
B53 + B80 |
0 |
L2 |
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C3. Commissions and Rev Sharing |
B3 |
0 |
L3 |
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D2.b Facility-Specific Site Com |
G4* |
0 |
L4 |
*Use the cell in the last column which depends on number of facilities reported. Instead of Cell G4, use e.g., Cell XYZ3. The actual column TBD. |
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Difference C3, D2.b |
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0 |
L5 = L4 - L3 |
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Percent Difference |
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#DIV/0! |
L6 = L4 / L3 - 1 |
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Difference C1-C2, C3 |
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0 |
L7 = L3 - L2 |
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Percent Difference |
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#DIV/0! |
L8 = L3 / L2 - 1 |
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Total Monetary Site Commissions |
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B. Overview Information |
B27 |
0 |
L1 = L2 |
Overview tab references Commission and Rev Sharing tab |
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C3. Commissions and Rev Sharing |
B7 + B17 |
0 |
L2 |
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D2.b Facility-Specific Site Com |
G12 + G35* |
0 |
L3 |
*Use the cell in the last column which depends on number of facilities reported. Instead of Cell G12, use e.g., Cell XYZ11. The actual column TBD. |
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Difference C3, D2.b |
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0 |
L4 = L3 - L2 |
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Percent Difference |
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#DIV/0! |
L5 = L3 / L2 - 1 |
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Safety and Security Expense |
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B. Overview Information |
B12 |
0 |
L1 = L2 |
Overview tab references Company-wide tab |
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C1-C2. Company-Wide Information |
E90 |
0 |
L2 |
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C3. Safety & Security Measures |
M15 |
0 |
L3 |
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D2.d. Facilities' S&S Costs |
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Included for comprehensiveness. Cost that is incurred by the incarceration authority does not relate to any of the above. |
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Difference C1-C2, C3 |
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0 |
L4 = L3 - L2 |
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Percent Difference |
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#DIV/0! |
L5 = L3 / L2 - 1 |
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Safety and Security Audio |
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C3. Safety & Security Measures |
I15 |
0 |
L1 |
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D2.c. Fac-Spec S&S - Audio IPCS |
G11* |
0 |
L2 |
*Use the cell in the last column which depends on number of facilities reported. Instead of Cell G11, use e.g., Cell XYZ11. The actual column TBD. |
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Difference C3, D2c |
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0 |
L3 = L2 - L1 |
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Percent Difference |
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#DIV/0! |
L4 = L2 / L1 - 1 |
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Safety and Security Video |
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C3. Safety & Security Measures |
J15 |
0 |
L1 |
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D2.c. Fac-Spec S&S - Video IPCS |
G11* |
0 |
L2 |
*Use the cell in the last column which depends on number of facilities reported. Instead of Cell G11, use e.g., Cell XYZ11. The actual column TBD. |
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Difference C3, D2c |
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0 |
L3 = L2 - L1 |
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Percent Difference |
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#DIV/0! |
L4 = L2 / L1 - 1 |
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Audio IPCS Costs |
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B. Overview Information |
B10 |
0 |
L1 = L2 |
Overview tab references Company-wide tab |
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C1-C2. Company-Wide Information |
C90 |
0 |
L2 |
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D1. Facility Audio IPCS Costs |
G101* |
0 |
L3 |
*Use the cell in the last column which depends on number of facilities reported. Instead of Cell G62, use e.g., Cell XYZ62. The actual column TBD. |
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Difference C1-C2, D1 |
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0 |
L4 = L3 - L2 |
This difference may be slightly higher, because the tabs use different tax rates (e.g., weighted avg. v. state specific). |
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Percent Difference |
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#DIV/0! |
L5 = L3 / L2 - 1 |
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Video IPCS Costs |
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B. Overview Information |
B11 |
0 |
L1 = L2 |
Overview tab references Company-wide tab |
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C1-C2. Company-Wide Information |
D90 |
0 |
L2 |
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D1. Facility Video IPCS Costs |
G101* |
0 |
L3 |
*Use the cell in the last column which depends on number of facilities reported. Instead of Cell G62, use e.g., Cell XYZ62. The actual column TBD. |
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Difference C1-C2, D1 |
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0 |
L4 = L3 - L2 |
This difference may be slightly higher, because the tabs use different tax rates (e.g., weighted avg. v. state specific). |
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Percent Difference |
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#DIV/0! |
L5 = L3 / L2 - 1 |
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Permissible Ancillary Service Costs |
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B. Overview Information |
Sum(B13:B17) |
0 |
L1 = L2 |
Overview tab references Company-wide tab (does not include Other Ancillary from Company-wide) |
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C1-C2. Company-Wide Information |
Sum(F90:J90) |
0 |
L2 |
Automated Payment, Live Agent, Paper Bill/Statement, Single-Call and Related, Third-Party Financial Transaction |
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C3. Commissions and Rev Sharing |
B34 + B40 + B46 + B52 + B58 |
0 |
L3 |
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Difference C1-C2, C3 |
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0 |
L4 = L3 - L2 |
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Percent Difference |
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#DIV/0! |
L5 = L3 / L2 - 1 |
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Total Revenue (minus Other) |
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B. Overview Information |
Sum(B18:B25) |
0 |
L1 = L2 |
Overview tab references Company-wide tab |
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C1-C2. Company-Wide Information |
B4 - K4 - L4 |
0 |
L2 |
Company-Wide minus Other Ancillary Services minus Other Products and Services |
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D1. Facility Demand and Revenue |
G55 + G60 + G71* |
0 |
L3 |
Audio + Video + Permissible Ancillary Services; Use the last column which depends on number of facilities reported |
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Difference C1-C2, D1 |
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0 |
L4 = L3 - L2 |
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Percent Difference |
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#DIV/0! |
L5 = L3 / L2 - 1 |
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Audio Revenue |
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B. Overview Information |
B18 |
0 |
L1 = L2 |
Overview tab references Company-wide tab |
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C1-C2. Company-Wide Information |
C4 |
0 |
L2 |
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D1. Facility Demand and Revenue |
G55* |
0 |
L3 |
*Use the cell in the last column which depends on number of facilities reported. Instead of Cell G55, use e.g., Cell XYZ55. The actual column TBD. |
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Difference C1-C2, D1 |
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0 |
L4 = L3 - L2 |
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Percent Difference |
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#DIV/0! |
L5 = L3 / L2 - 1 |
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Video Revenue |
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B. Overview Information |
B19 |
0 |
L1 = L2 |
Overview tab references Company-wide tab |
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C1-C2. Company-Wide Information |
D4 |
0 |
L2 |
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D1. Facility Demand and Revenue |
G60* |
0 |
L3 |
*Use the cell in the last column which depends on number of facilities reported. Instead of Cell G60, use e.g., Cell XYZ60. The actual column TBD. |
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Difference C1-C2, D1 |
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0 |
L4 = L3 - L2 |
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Percent Difference |
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#DIV/0! |
L5 = L3 / L2 - 1 |
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Permissible Ancillary Services Revenues |
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B. Overview Information |
Sum(B21:B25) |
0 |
L1 = L2 |
Overview tab references Company-wide tab (Other Ancillary is not included) |
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C1-C2. Company-Wide Information |
Sum(F4:J4) |
0 |
L2 = L3 |
Automated Payment, Live Agent, Paper Bill/Statement, Single-Call and Related, Third-Party Financial Transaction |
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C3. Commissions and Rev Sharing |
B72 + B75 + B77 + B78 + B81 |
0 |
L3 |
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D2.e. Facility-Spec Ancillary |
H4 + H10 + H18 + H24 + H30* |
0 |
L4 |
Automated Payment, Live Agent, Paper Bill/Statement, Single-Call and Related, Third-Party Financial Transaction; *Use the last column , e.g., Cell XYZ3 + … The actual column TBD. |
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Difference C3, D2.e. |
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0 |
L5 = L4 - L3 |
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Percent Difference |
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#DIV/0! |
L6 = L4 / L3 - 1 |
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Number of Facilities |
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A. General Information |
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no count |
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B. Overview Information |
B3 |
0 |
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C1. Company-Wide Information |
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no count |
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C2. Commissions and Rev Sharing |
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no count |
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C3. Safety & Security Measures |
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no count |
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D1. Facility Audio IPCS Costs |
H4 |
5 |
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Cell reference will change to reflect count of facilities |
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D1. Facility Video IPCS Costs |
H4 |
5 |
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D1. Facility Demand and Revenue |
H2 |
5 |
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D2.b Facility-Specific Site Com |
H3 |
5 |
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D2.c. Fac-Spec S&S - Audio IPCS |
H3 |
5 |
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D2.c. Fac-Spec S&S - Video |
H3 |
5 |
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D2.d. Facilities' S&S Costs |
H7 |
5 |
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D2.e. Facility-Spec Ancillary |
I2 |
5 |
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Do all facility counts match in all Tabs? |
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0 |
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Appendix B |
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Incarcerated People's Communications Services 2023 Mandatory Data Collection Proposed Excel Template |
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WC Docket Nos. 23-62, 12-375 |
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FCC Form 2303(a) |
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OMB Control No. 3060-XXXX / Not Approved by OMB |
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Estimated Time Per Response: 260 Hours |
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A. General Company Information |
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(1) Company Name |
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(2) Accounting Entity |
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(3) Contact Person Information |
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Name |
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Title |
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Email Address |
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Phone Number |
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(4) Holding Company Name |
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(5) Filing Date (MM/DD/YYYY) |
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(6) Headquarters Address |
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(7) Publicly Listed (Yes/No) |
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2022 General Company Information |
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(8a) List all IPCS-Related Services or any Ancillary Services that the Company provided at or for Facilities, or to Incarcerated People or those they communicate with, during 2022. List all such services even if the Company only provided them at some Facilities. |
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(9a) List all Business Segments, other than IPCS or Ancillary Services, that the Company engaged in during 2022. |
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(9b) 2022 Billed Revenues for each Listed Business Segment during 2022. |
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(9c) List all Business Segments, other than IPCS or Ancillary Services, the Company or an Affiliate provided at or for Facilities, or to Incarcerated People or those they communicate with, during 2022. List all Business Segments even if the Company or Affiliate provided them only at some Facilities. |
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(10a) List each type of tangible and intangible asset attributable to providing IPCS or Ancillary Services during 2022. Exclude any type of asset whose Net Investment is less than 5% of the Company’s total Net Investment. |
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(10b) Provide the Net Investment in each Listed Type of Asset as of December 31, 2022. |
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(10c) List each Audio IPCS or Video IPCS or Ancillary Service, if any, that each Type of Asset Supported |
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(10d) List each Non-IPCS-Related Product or Service, if any, that each Type of Asset Supported |
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(11) List the Names of all of the Company’s Affiliates, other than Affiliates that provided IPCS or Ancillary Services, during 2022. |
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(12) Billed Revenues of Affiliates Other Than Affiliates that Provided IPCS or Ancillary Services for 2022. |
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(13a) List all Business Segments in Which Affiliates, other than Affiliates that provided IPCS or Ancillary Services, engaged during 2022. |
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(13b) Identify each Affiliate, other than Affiliates that provided IPCS or Ancillary Services, that participated in the supply of each Business Segment on your list. |
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(14) Enter Billed Revenues for 2022 by each Affiliate, other than Affiliates that provided IPCS or Ancillary Service, for each Business Segment on your list. |
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(15) List All Types of Assets and Services that the Company Obtained from an Affiliate, other than an Affiliate that provided IPCS or Ancillary Services, that were used in the provision of IPCS or Ancillary Services during 2022. |
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(15a) Each Affiliate, other than an Affiliate that provided IPCS or Ancillary Services, that provided those assets or services |
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(15b) The Amounts the Company Paid its Affiliates, other than Affiliates that provided IPCS or Ancillary Services, for those assets and services |
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(15c) The Net Investment of Affiliates, other than Affiliates that provided IPCS or Ancillary Services, in those assets as of the date of the transaction. |
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(15d) The Annual Total Expenses that Affiliates, other than Affiliates that provided IPCS or Ancillary Services, incurred to provide those services during the year immediately prior to the transaction. |
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Company-Wide and Service Specific Financial Information for 2022 |
Revenue, Investment, or Expense Item |
Company Wide |
Services |
Audio IPCS |
Video IPCS |
Safety and Security Measures |
Automated Payment Services |
Live Agent Services |
Paper Bill/Statement Services |
Single-Call and Related Services |
Third-Party Financial Transaction Services |
Other Ancillary Services |
Other Products and Services |
Total Billed Revenues |
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Investments and Expenses |
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Capital Assets: |
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Tangible Assets |
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Gross Investment |
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Accumulated Depreciation |
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Net Investment [row 8 - row 9] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Capitalized Research and Development |
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Gross Investment |
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Accumulated Amortization |
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Net Investment [row 12 - row 13] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Purchased Software |
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Gross Investment |
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Accumulated Amortization |
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Net Investment [row 16 - row 17] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Internally Developed Software |
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Gross Investment |
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Accumulated Amortization |
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Net Investment [row 20 - row 21] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Trademarks |
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Gross Investment |
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Accumulated Amortization |
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Net Investment [row 24 - row 25] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Capitalized Site Commissions |
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Gross Investment |
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N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
Accumulated Amortization |
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N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
Net Investment [row 28 - row 29] |
0 |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
Other Identifiable Intangible Assets |
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Gross Investment |
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Accumulated Amortization |
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Net Investment [row 32 - row 33] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Goodwill |
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Gross Investment |
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Accumulated Amortization |
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Net Investment [row 36 - row 37] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Gross Investment in Assets [row 8 + row 12 + row 16 + row 20 + row 24 + row 28 + row 32 + row 36; or row 8 + row 12 + row 16 + row 20 + row 24 + row 32 + row 36] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Accumulated Depreciation and Amortization of Assets [row 9 + row 13 + row 17 + row 21 + row 25 + row 29 + row 33 + row 37; or row 9 + row 13 + row 17 + row 21 + row 25 + row 33 + row 37] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Net Investment in Assets [row 39 - row 40] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Accumulated Deferred Federal Income Taxes |
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Accumulated Deferred State Income Taxes |
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Customer Prepayments or Deposits |
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Cash Working Capital (report "0" unless you elect in cell B160) |
N/A |
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N/A |
N/A |
Net Capital Stock [row 41 - row 42 - row 43 - row 44 + row 45] |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
N/A |
N/A |
Capital Expenses: |
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Depreciation - Tangible Assets |
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Amortization - Capitalized Research and Development |
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Amortization - Purchased Software |
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Amortization - Internally Developed Software |
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Amortization - Trademarks |
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Amortization - Capitalized Site Commissions (include amortization recognized as an offset against gross revenues) |
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N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
Amortization - Other Identifiable Intangible Assets |
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Amortization - Goodwill |
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Depreciation and Amortization of Assets [row 48 + row 49 + row 50 + row 51 + row 52 + row 53 + row 54 + row 55; or row 48 + row 49 + row 50 + row 51 + row 52 + row 54 + row 55] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Weighted Average Cost of Capital (report the WACC reported in cell B156 if you elect to claim a WACC greater than 9.75%) |
N/A |
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N/A |
N/A |
Return [row 57 x row 46] |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
N/A |
N/A |
Interest Other than Interest Paid on Customer Prepayments or Deposits |
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Interest Paid on Customer Prepayments or Deposits |
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Other Income Tax-Related Adjustments |
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Federal Taxable Income [row 58 - row 59 - row 61] |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
N/A |
N/A |
Federal Income Tax Rate |
N/A |
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N/A |
N/A |
Federal Income Tax Gross-Up Factor [row 63/(1 - row 63)] |
N/A |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
N/A |
N/A |
Federal Income Tax [row 64 x row 62] |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
N/A |
N/A |
Federal Income Tax Not Deductible for State Income Tax Purposes |
N/A |
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N/A |
N/A |
State Taxable Income [row 62 + row 66] |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
N/A |
N/A |
State Income Tax Rate (weighted average of the individual state income tax rates from cell C147) |
N/A |
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8.00% |
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N/A |
N/A |
State Income Tax Gross-Up Factor [row 68 /(1 - row 68)] |
N/A |
0.00% |
8.70% |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
N/A |
N/A |
State Income Tax [row 69 x row 67] |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
N/A |
N/A |
Total Capital Expenses [row 56 + row 58 + row 60 + row 65 + row 70] |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
N/A |
N/A |
Operating Expenses: |
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Maintenance, Repair, and Engineering of Site Plant, Equipment, and Facilities |
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Payments to Telecommunications Carriers or Other Entities for Interstate, International, or Intrastate Communications Other Than Extra Payments to Telecommunications Carriers or Other Entities for International Communications |
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Extra Payments to Telecommunications Carriers or Other Entities for International Communications |
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Field Services |
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Network Operations |
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Call Center |
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Data Center and Storage |
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Payment of Site Commissions Recognized as an Expense or an Offset Against Gross Revenues When Paid or When Commissions-Related Transaction Occurred |
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N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
Billing, Collection, Client Management, and Customer Care |
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Sales and Marketing |
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General and Administrative |
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Other Overhead |
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Taxes Other than Income Taxes |
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Transactions Related to Mergers and Acquisitions |
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Bad Debt |
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Total Operating Expenses [sum of rows 73-87; or sum of rows 73-79 + sum of rows 81-87] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Total Operating Expenses Excluding Extra Payments to Telecommunications Carriers or Other Entities for International Communications [row 88 - row 75] |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Annual Total Expenses Excluding Extra Payments to Telecommunications Carriers or Other Entities for International Communications [row 71 + row 89] |
N/A |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
N/A |
N/A |
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Weighted Average of the Individual State Income Tax Rates for 2022 |
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State |
Enter “C” if the Company is subject to the state corporate income tax rate, or “PTE” if the Company passes income through to its owners |
State Income Tax Rate (%) |
IPCS and Ancillary Services Billed Revenues ($) |
Percent of Total IPCS and Ancillary Services Billed Revenues ($) |
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Weighted Average of the Individual State Income Tax Rates (sum of the products of column B and column D) or Total |
|
0.00% |
0 |
0.00% |
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Weighted Average Cost of Capital for 2022 |
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Enter "Y" if you elect to claim a WACC other than 9.75%. If you enter "Y" and claim a WACC greater than 9.75% on row 57, report the components of the WACC and the WACC itself, as specified below. |
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Type of Capital |
Cost (%) |
Capital Outstanding ($) |
Percent of Total Capital Outstanding (%) |
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Debt |
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Preferred Stock |
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Equity |
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Weighted Average Cost of Capital (sum of the products of col. B and col. D) or Total |
0.00% |
0 |
0.00% |
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Cash Working Capital for 2022 |
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Enter "Y" if you elect to claim an allowance for Cash Working Capital. If you enter "Y," report the allowances claimed for Cash Working Capital on row 45 separately for Audio IPCS, Video IPCS, Automated Payment Services, Live Agent Services, Paper Bill/Statement Services, Single-Call and Related Services, and Third-Party Financial Transaction Services. |
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Company-Wide Site Commissions for 2022 |
a. Site Commissions and Revenue Sharing |
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(1) Total Site Commissions |
|
(a) Percentage of Total Site Commissions Paid by the Company During 2022 that were Attributable to the Company’s provision of IPCS and associated Ancillary Services |
|
(b) Percentage of Total Site Commissions Paid by the Company During 2022 that were Attributable to the Company’s provision of Safety and Security Measures |
|
(2) Total Legally Mandated Site Commissions |
0 |
(a) Total Monetary Site Commissions: Total Legally Mandated, Monetary Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services |
0 |
(i) Total Fixed Site Commissions: Total Legally Mandated Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were both Monetary Site Commissions and Fixed Site Commissions |
|
(aa) Total Upfront Payments: Total Legally Mandated Site Commissions for 2022 for IPCS and associated Ancillary Services that not only were Monetary Site Commissions and Fixed Site Commissions but also were paid by the Company at the signing of a contract for IPCS or during the first year of a contract for these services |
|
(ii) Total Variable Site Commissions: Total amount of all Legally Mandated Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were both Monetary Site Commissions and Variable Site Commissions |
|
(b) Total In-Kind Site Commissions: Total amount of all Legally Mandated Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were also In-Kind Site Commissions. |
|
(i) Word template entry |
|
(ii) Total Fixed Site Commissions: Total amount of all Legally Mandated Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were both In-Kind Site Commissions and Fixed Site Commissions |
|
(aa) Total Upfront Payments: Total amount of all Legally Mandated Site Commissions for 2022 for IPCS and associated Ancillary Services that not only were In-Kind Site Commissions and Fixed Site Commissions but also were paid by the Company at the signing of a contract for IPCS or during the first year of a contract for these services |
|
(iii) Total Variable Site Commissions: Total amount of all Legally Mandated Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were both In-Kind Site Commissions and Variable Site Commissions. |
|
(3) Total Contractually Prescribed Site Commissions |
0 |
(a) Total Monetary Site Commissions: Total Contractually Prescribed Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were also Monetary Site Commissions |
0 |
(i) Total Fixed Site Commissions: Total amount of all Contractually Prescribed Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were both Monetary Site Commissions and Fixed Site Commissions |
|
(aa) Total Upfront Payments: Total amount of all Contractually Prescribed Site Commissions for 2022 for IPCS and associated Ancillary Services that not only were Monetary Site Commissions and Fixed Site Commissions but also were paid by the Company at the signing of a contract for IPCS or during the first year of a contract for these services |
|
(ii) Total Variable Site Commissions: Total amount of all Contractually Prescribed Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were both Monetary Site Commissions and Variable Site Commissions |
|
(b) Total In-Kind Site Commissions: Total amount of Contractually Prescribed Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were also In-Kind Site Commissions. |
|
(i) Word template entry |
|
(ii) Total Fixed Site Commissions: Total amount of all Contractually Prescribed Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were both In-Kind Site Commissions and Fixed Site Commissions |
|
(aa) Total Upfront Payments: Total amount of all Contractually Prescribed Site Commissions for 2022 for IPCS and associated Ancillary Services that not only were In-Kind Site Commissions and Fixed Site Commissions but also were paid by the Company at the signing of a contract for IPCS or during the first year of a contract these services. |
|
(iii) Total Variable Site Commissions: Total amount of all Contractually Prescribed Site Commissions paid by the Company during 2022 for IPCS and associated Ancillary Services that were both In-Kind Site Commissions and Variable Site Commissions. |
|
(4) - (8) Word template entries |
|
b. Company-Wide Costs of Provider’s’ Safety and Security Measures (see tab C3 S&S Measures) |
|
c. Service-Specific Costs of Providing Safety and Security Measures (see tab C3 S&S Measures) |
|
d. Ancillary Services |
|
(1) Ancillary Services: Enter “Yes” if the Company charged Customers Automated Payment Service Fees, Live Agent Service Fees, Paper Bill/Statement Service Fees, Fees for Single-Call and Related Services, Third-Party Financial Transaction Services Fees, or Other Ancillary Services Fees during 2022. Otherwise, enter “No.” |
|
(a) Enter “Yes” if the Company charged Customers more than one Permissible Ancillary Service Charge fee in connection with the same interstate, international, or mixed-jurisdictional transaction during 2022 |
|
(b) - (c) Word template entry |
|
(2) Ancillary Service Expenses: Annual Total Expenses incurred in providing Automated Payment Services, Paper Bill/Statement Services, Live Agent Services, Single-Call and Related Services, and Third Party Financial Transaction Services during 2022 [Company-Wide Information, sum of F90, G90, H90, I90, and J90] |
0 |
(a) Automated Payment Services: Annual Total Expenses the Company incurred in providing Automated Payment Service during 2022 [Company-Wide Information, F90] |
0 |
(i) Identify each Affiliate, if any, that the Company used in providing its Automated Payment Services during 2022 |
|
(ii) Enter “Yes” if the Company used a Third Party in providing its Automated Payment Services during 2022. Otherwise Enter “No.” |
|
(aa) If you Entered "Yes," identify each such Third Party; and |
|
(ab) Enter the amount the Company paid, separately and individually, to each listed Third Party for providing Automated Payment Services during 2022 |
|
(iii) Word template entry |
|
(b) Live Agent Services: Annual Total Expenses the Company incurred in providing Live Agent Services during 2022 [Company-Wide Information, G90] |
0 |
(i) Identify each Affiliate, if any, that the Company used in providing its Live Agent Services during 2022 |
|
(ii) Enter "Yes" if the Company used a Third Party in providing its Live Agent Services during 2022. Otherwise enter “No.” |
|
(aa) If you Entered "Yes," identify each such Third Party; and |
|
(ab) Enter the amount the Company paid, separately and individually, to each listed Third Party during 2022 to provide Live Agent Services |
|
(iii) Word template entry |
|
(c) Paper Bill/Statement Services: Annual Total Expenses the Company incurred in providing Paper Bill/Statement Services during 2022 [Company-Wide Information, H90] |
0 |
(i) Identify each Affiliate that the Company used in providing its Paper Bill/Statement Services during 2022 |
|
(ii) Enter "Yes" if the Company used a Third Party in providing its Paper Bill/Statement Services during 2022. Otherwise, enter “No.” |
|
(aa) If you Entered "Yes," identify each such Third Party; and |
|
(ab) Enter the amount the Company paid, separately and individually, each listed Third Party during 2022 to provide Paper Bill/Statement Services |
|
(iii) Word template entry |
|
(d) Single-Call and Related Services: Annual Total Expenses the Company incurred in providing Single-Call and Related Services during 2022 [Company-Wide Information, I90] |
0 |
(i) List each entity that charged the Company for billing services in connection with Single-Call and Related Services during 2022. Indicate whether each listed entity is a Third Party. |
|
(ii) For each such Third Party, enter the amount the Company paid that Third Party for billing services in connection with Single-Call and Related Services during 2022 |
|
(iii) From the amount the Company paid each Third Party for billing services in connection with Single-Call and Related Services, enter the amount that the Company passed through to Customers during 2022 |
|
(iv) Enter the amount the Company paid to any entity other than a Third Party for billing services in connection with Single-Call and Related Services during 2022 |
|
(v) From the amount the Company paid to any entity other than a Third Party for billing services in connection with Single-Call and Related Services during 2022, enter the amount that the Company passed through to Customers. |
|
(e) Third Party Financial Transaction Services: Annual Total Expenses the Company incurred in providing Third Party Financial Services during 2022 [Company-Wide Information, J90] |
0 |
(i) List each entity that charged the Company for providing Third-Party Financial Transaction Services during 2022 in connection with the Company’s IPCS. Indicate whether each listed entity is a Third Party. |
|
(ii) For each such Third Party, enter the amount the Company paid to that Third Party for Third-Party Financial Transaction Services during 2022 |
|
(iii) From the amount the Company paid to each Third Party for Third-Party Financial Transaction Services, enter the amount that the Company passed through to Customers during 2022 |
|
(iv) Enter the amount the Company paid to itself or an Affiliate for Third-Party Financial Transaction Services during 2022. |
|
(v) From the amount the Company paid to itself or an Affiliate for Third-Party Financial Transaction Services during 2022, enter the amount that the Company passed through to Customers. |
|
(vi) - (vii) Word template entries |
|
(f) Other Ancillary Services: |
|
(i) Identify each Affiliate, if any, that the Company used in providing its Other Ancillary Services during 2022 |
|
(ii) Enter “Yes” if the Company used a Third Party in providing its Other Ancillary Services during 2022. Otherwise Enter “No.” |
|
(aa) If you Entered "Yes," identify each such Third Party; and |
|
(ab) Enter the amount the Company paid, separately and individually, to each listed Third Party for providing Other Ancillary Services during 2022 |
|
(iii) - (iv) Word template entry |
|
(3) Ancillary Services Revenues: Total revenues received from Customers for providing Ancillary Services during 2022 (i.e., fees Customers paid the Company for Automated Payment Services, Live Agent Services, Paper Bill/Statement Services, Single-Call and Related Services, Third-Party Financial Transaction Services, and Other Ancillary Services) [Company-Wide Information, sum of F4, G4, H4, I4, J4, and K4] |
0 |
(a) Automated Payment Service Revenues: Total Amount of Revenues received from charging Automated Payment Fees during 2022 [Company-Wide Information, F4] |
0 |
(i) Payment Card Processing Revenues for Automated Payment Service: Of the amount reported for total Automated Payment Fees revenues above during 2022, enter the amount of those revenues from payment card processing. |
|
(ii) Automated Payment Service Revenue-Sharing Agreements: If the Company has a Revenue-Sharing Agreement with an Affiliate or Third Party in connection with Automated Payment Services, including for any payment card processing functions, enter “Yes.” Otherwise, enter “No.” |
|
(b) Live Agent Fee Revenues: Total revenues the Company received from charging Live Agent Fees during 2022 [Company-Wide Information, G4] |
0 |
(i) Enter “Yes” if an Affiliate or Third Party charged Live Agent Fees during 2022. Otherwise, enter “No.” If you entered “Yes,” identify each such Affiliate or Third Party and provide the amount charged by each respective Affiliate or Third Party next to its name. |
|
(c) Paper Bill/Statement Fee Revenues: Total revenues the Company received from charging Paper Bill/Statement Fees during 2022 [Company-Wide Information, H4] |
0 |
(d) Single-Call and Related Sevices Revenues: Total revenue the Company received during 2022 from charging Fees for Single-Call and Related Services [Company-Wide Information, I4] |
0 |
(i) Single-Call and Related Services Revenue Sharing Agreements: if the Provider has a Revenue-Sharing Agreement with an Affiliate or a Third Party in connection with Single-Call and Related Services enter “Yes.” Otherwise, enter “No.” |
|
(aa) Word template entry |
|
(e) Third Party Financial Transaction Fee Revenue: Total revenues the Company received from charging Third-Party Financial Transaction Fees during 2022 [Company-Wide Information, J4] |
0 |
(i) Payment Card Processing Revenues from Third-Party Financial Transaction Services: Of the amount reported for Total Third-Party Financial Transaction Fee Revenue above during 2022, enter the amount of that revenue applicable to payment card processing services. |
|
(aa) Word template entry |
|
(f) Payment Card Processing Fees: If the Company charged Customers payment card processing fees during 2022, enter the amount of such fees charged to Customers during 2022. Otherwise, enter zero. |
|
(g) Third-Party Financial Transaction Fee Revenue Sharing Agreements: If the Provider has a Revenue-Sharing Agreement with an Affiliate or a Third Party in connection with Third-Party Financial Transaction Fees, enter “Yes.” Otherwise, enter “No.”
Word template entry if "Yes" |
|
(h) Other Ancillary Services Revenue: Total revenues the Company received from charging Other Ancillary Services Fees during 2022 |
0 |
(i) Payment Card Processing Revenues from from Other Ancillary Services: Of the amount reported for each of the Total Other Ancillary Services Revenue above during 2022, enter the amount of that revenue applicable to payment card processing. |
|
(aa) Word template entry |
|
(ii) Other Ancillary Services Revenue-Sharing Agreements: If the Provider has a Revenue-Sharing Agreement with an Affiliate or a Third Party in connection with Other Ancillary Services offered, enter “Yes.” Otherwise, enter “No.” |
|
(iii) Word template entry |
|
(4) - (6) Word template entry |
|
e. Affiliate Transactions |
|
(1) Word template entry |
|
(2) Provider's Transactions with Non-Accounting Entity Affiliates |
|
(a) Total IPCS Revenue Passed Through to Non-Accounting Entity Affiliates: Enter the amount of IPCS revenue passed through to any non-Accounting Entity Affiliate during 2022. |
|
(b) Total Automated Payment Fee Revenue Passed Through to Non-Accounting Entity Affiliates: Enter the amount of Automated Payment Fee revenue the Provider passed through to any non-Accounting Entity Affiliate during 2022. |
|
(c) Total Single-Call and Related Services Revenue Passed Through to Non-Accounting Entity Affiliates: Enter the amount of revenue from charging Fees for Single-Call and Related Services the Provider passed through to any non-Accounting Entity Affiliate during 2022. |
|
(d) Total Live Agent Fee Revenue Passed Through to Non-Accounting Entity Affiliates: Enter the amount of Live Agent Fee revenue the Provider passed through to any non-Accounting Entity Affiliate during 2022. |
|
(e) Total Paper Bill/Statement Fee Revenue Passed Through to Non-Accounting Entity Affiliates: Enter the amount of Paper Bill/Statement Fee revenue the Provider passed through to any non-Accounting Entity Affiliate during 2022. |
|
(f) Total Third-Party Financial Transaction Fee Revenue Passed Through to Non-Accounting Entity Affiliates: Enter the amount of Third-Party Financial Transaction Fee revenue the Provider passed through to any non-Accounting Entity Affiliate during 2022. |
|
(g) International Termination Payments to Non-Accounting Entity Affiliates: Enter the Company’s total payments to any non-Accounting Entity Affiliate during 2022 to complete International Communications for Incarcerated People. |
|
D1. Facility-Specific Audio IPCS Costs For 2022 |
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a. General Information |
|
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|
(1) Unique Contract Identifier |
|
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|
|
(2) Unique Facility Identifier |
|
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|
|
Total |
5 |
Count |
(3) Contractor Name |
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(4) Subcontractor Name |
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(5) Counterparty to Contract |
|
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(6)(a) Facility Street Number and Street Name |
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(6)(b) Facility Building Identifier (if any) |
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(6)(c) Facility City |
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(6)(d) Facility State |
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(6)(e) Facility Zip Code |
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(7) Facility Geographic Coordinates |
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(8) Facility Type (Jail (J) or Prison (P)) |
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(9) Maximum Audio Communication Duration |
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b. Cost Allocation Results |
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1. Capital Assets: |
|
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(i) Tangible Assets |
|
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(a) Gross Investment |
|
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(b) Accumulated Depreciation |
|
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|
(d) Net Investment [row 19 - row 20] |
0 |
0 |
0 |
0 |
0 |
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(ii) Capitalized Research and Development |
|
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(a) Gross Investment |
|
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|
(c) Accumulated Amortization |
|
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|
(d) Net Investment [row 23 - row 24] |
0 |
0 |
0 |
0 |
0 |
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|
(iii) Purchased Software |
|
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|
(a) Gross Investment |
|
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(c) Accumulated Amortization |
|
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|
(d) Net Investment [row 27 - row 28] |
0 |
0 |
0 |
0 |
0 |
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|
(iv) Internally Developed Software |
|
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|
(a) Gross Investment |
|
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(c) Accumulated Amortization |
|
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|
(d) Net Investment [row 31 - row 32] |
0 |
0 |
0 |
0 |
0 |
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|
(v) Trademarks |
|
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|
(a) Gross Investment |
|
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|
(c) Accumulated Amortization |
|
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|
(d) Net Investment [row 35 - row 36] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Capitalized Site Commissions |
|
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|
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|
|
Gross Investment |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
Accumulated Amortization |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
Net Investment |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
(vi) Other Identifiable Intangible Assets |
|
|
|
|
|
|
|
|
(a) Gross Investment |
|
|
|
|
|
|
|
|
(c) Accumulated Amortization |
|
|
|
|
|
|
|
|
(d) Net Investment [row 43 - row 44] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(vii) Goodwill |
|
|
|
|
|
|
|
|
(a) Gross Investment |
|
|
|
|
|
|
|
|
(c) Accumulated Amortization |
|
|
|
|
|
|
|
|
(d) Net Investment [row 47 - row 48] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Gross Investment in Assets [row 19 + row 23 + row 27 + row 31 + row 35 + row 43 + row 47] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Accumulated Depreciation and Amortization of Assets [row 20 + row 24 + row 28 + row 32 + row 36 + row 44 + row 48] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Net Investment in Assets [row 50 - row 51] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(e) Accumulated Deferred Federal Income Taxes |
|
|
|
|
|
|
|
|
(f) Accumulated Deferred State Income Taxes |
|
|
|
|
|
|
|
|
(g) Customer Prepayments or Deposits |
|
|
|
|
|
|
|
|
(h) Cash Working Capital (report "0" unless you elect to claim an allowance) |
|
|
|
|
|
|
|
|
(i) Net Capital Stock [row 52 - row 53 - row 54 - row 55 + row 56] |
0 |
0 |
0 |
0 |
0 |
|
|
|
2. Capital Expenses: |
|
|
|
|
|
|
|
|
(i)(a) Depreciation - Tangible Assets |
|
|
|
|
|
|
|
|
(ii)(b) Amortization - Capitalized Research and Development |
|
|
|
|
|
|
|
|
(iii)(b) Amortization - Purchased Software |
|
|
|
|
|
|
|
|
(iv)(b) Amortization - Internally Developed Software |
|
|
|
|
|
|
|
|
(v)(b) Amortization - Trademarks |
|
|
|
|
|
|
|
|
Amortization - Capitalized Site Commissions (include amortization recognized as an offset against gross revenues) |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
(vi)(b) Amortization - Other Identifiable Intangible Assets |
|
|
|
|
|
|
|
|
(vii)(b) Amortization - Goodwill |
|
|
|
|
|
|
|
|
Depreciation and Amortization of Assets [row 59 + row 60 + row 61 + row 62 + row 63 + row 65 + row 66] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(c) Weighted Average Cost of Capital |
|
|
|
|
|
|
|
|
(d) Return [row 68 x row 57] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(e) Interest Other than Interest Paid on Customer Prepayments or Deposits |
|
|
|
|
|
|
|
|
(f) Interest Paid on Customer Prepayments or Deposits |
|
|
|
|
|
|
|
|
(g) Other Income Tax-Related Adjustments |
|
|
|
|
|
|
|
|
(h) Federal Taxable Income [row 69 - row 70 - row 72] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(i) Federal Income Tax Rate |
|
|
|
|
|
|
|
|
(j) Federal Income Tax Gross-Up Factor [row 74/(1 - row 74)] |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
|
|
|
(k) Federal Income Tax [row 75 x row 73] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(l) Federal Income Tax Not Deductible for State Income Tax Purposes |
|
|
|
|
|
|
|
|
(m) State Taxable Income [row 73 + row 77] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(n) State Income Tax Rate |
|
|
|
|
|
|
|
|
(o) State Income Tax Gross-Up Factor [row 79 /(1 - row 79)] |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
|
|
|
(p) State Income Tax [row 80 x row 78] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Total Capital Expenses [row 67 + row 69 + row 71 + row 76 + row 81] |
0 |
0 |
0 |
0 |
0 |
|
|
|
3. Operating Expenses: |
|
|
|
|
|
|
|
|
(a) Maintenance, Repair, and Engineering of Site Plant, Equipment, and Facilities |
|
|
|
|
|
|
|
|
(b) Payments to Telecommunications Carriers or Other Entities for Interstate, International, or Intrastate Communications Other Than Extra Payments to Telecommunications Carriers or Other Entities for International Communications |
|
|
|
|
|
|
|
|
(c) Extra Payments to Telecommunications Carriers or Other Entities for International Communications |
|
|
|
|
|
|
|
|
(d) Field Services |
|
|
|
|
|
|
|
|
(e) Network Operations |
|
|
|
|
|
|
|
|
(f) Call Center |
|
|
|
|
|
|
|
|
(g) Data Center and Storage |
|
|
|
|
|
|
|
|
Payment of Site Commissions Recognized as an Expense or an Offset Against Gross Revenues When Paid or When the Commissions-Related Transaction Occurred |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
(h) Billing, Collection, Client Management, and Customer Care |
|
|
|
|
|
|
|
|
(i) Sales and Marketing |
|
|
|
|
|
|
|
|
(j) General and Administrative |
|
|
|
|
|
|
|
|
(k) Other Overhead |
|
|
|
|
|
|
|
|
(l) Taxes Other than Income Taxes |
|
|
|
|
|
|
|
|
(m) Transactions Related to Mergers and Acquisitions |
|
|
|
|
|
|
|
|
(n) Bad Debt |
|
|
|
|
|
|
|
|
Total Operating Expenses [sum of rows 84-90 + sum of rows 92-98] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Total Operating Expenses Excluding Extra Payments to Telecommunications Carriers or Other Entities for International Communications [row 99 - row 86] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Annual Total Expenses for Audio IPCS Excluding Extra Payments to Telecommunications Carriers or Other Entities for International Communications [row 82 + row 100] |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
D1. Facility-Specific Video IPCS Costs For 2022 |
|
|
|
|
|
|
|
|
a. General Information |
|
|
|
|
|
|
|
|
(1) Unique Contract Identifier |
|
|
|
|
|
|
|
|
(2) Unique Facility Identifier |
|
|
|
|
|
Total |
5 |
Count |
(3) Contractor Name |
|
|
|
|
|
|
|
|
(4) Subcontractor Name |
|
|
|
|
|
|
|
|
(5) Counterparty to Contract |
|
|
|
|
|
|
|
|
(6)(a) Facility Street Number and Street Name |
|
|
|
|
|
|
|
|
(6)(b) Facility Building Identifier (if any) |
|
|
|
|
|
|
|
|
(6)(c) Facility City |
|
|
|
|
|
|
|
|
(6)(d) Facility State |
|
|
|
|
|
|
|
|
(6)(e) Facility Zip Code |
|
|
|
|
|
|
|
|
(7) Facility Geographic Coordinates |
|
|
|
|
|
|
|
|
(8) Facility Type (Jail (J) or Prison (P)) |
|
|
|
|
|
|
|
|
(10) Maximum Video Communication Duration |
|
|
|
|
|
|
|
|
b. Cost Allocation Results |
|
|
|
|
|
|
|
|
1. Capital Assets: |
|
|
|
|
|
|
|
|
(i) Tangible Assets |
|
|
|
|
|
|
|
|
(a) Gross Investment |
|
|
|
|
|
|
|
|
(b) Accumulated Depreciation |
|
|
|
|
|
|
|
|
(d) Net Investment [row 19 - row 20] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(ii) Capitalized Research and Development |
|
|
|
|
|
|
|
|
(a) Gross Investment |
|
|
|
|
|
|
|
|
(c) Accumulated Amortization |
|
|
|
|
|
|
|
|
(d) Net Investment [row 23 - row 24] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(iii) Purchased Software |
|
|
|
|
|
|
|
|
(a) Gross Investment |
|
|
|
|
|
|
|
|
(c) Accumulated Amortization |
|
|
|
|
|
|
|
|
(d) Net Investment [row 27 - row 28] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(iv) Internally Developed Software |
|
|
|
|
|
|
|
|
(a) Gross Investment |
|
|
|
|
|
|
|
|
(c) Accumulated Amortization |
|
|
|
|
|
|
|
|
(d) Net Investment [row 31 - row 32] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(v) Trademarks |
|
|
|
|
|
|
|
|
(a) Gross Investment |
|
|
|
|
|
|
|
|
(c) Accumulated Amortization |
|
|
|
|
|
|
|
|
(d) Net Investment [row 35 - row 36] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Capitalized Site Commissions |
|
|
|
|
|
|
|
|
Gross Investment |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
Accumulated Amortization |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
Net Investment |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
(vi) Other Identifiable Intangible Assets |
|
|
|
|
|
|
|
|
(a) Gross Investment |
|
|
|
|
|
|
|
|
(c) Accumulated Amortization |
|
|
|
|
|
|
|
|
(d) Net Investment [row 43 - row 44] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(vii) Goodwill |
|
|
|
|
|
|
|
|
(a) Gross Investment |
|
|
|
|
|
|
|
|
(c) Accumulated Amortization |
|
|
|
|
|
|
|
|
(d) Net Investment [row 47 - row 48] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Gross Investment in Assets [row 19 + row 23 + row 27 + row 31 + row 35 + row 43 + row 47] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Accumulated Depreciation and Amortization of Assets [row 20 + row 24 + row 28 + row 32 + row 36 + row 44 + row 48] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Net Investment in Assets [row 50 - row 51] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(e) Accumulated Deferred Federal Income Taxes |
|
|
|
|
|
|
|
|
(f) Accumulated Deferred State Income Taxes |
|
|
|
|
|
|
|
|
(g) Customer Prepayments or Deposits |
|
|
|
|
|
|
|
|
(h) Cash Working Capital (report "0" unless you elect to claim an allowance) |
|
|
|
|
|
|
|
|
(i) Net Capital Stock [row 52 - row 53 - row 54 - row 55 + row 56] |
0 |
0 |
0 |
0 |
0 |
|
|
|
2. Capital Expenses: |
|
|
|
|
|
|
|
|
(i)(a) Depreciation - Tangible Assets |
|
|
|
|
|
|
|
|
(ii)(b) Amortization - Capitalized Research and Development |
|
|
|
|
|
|
|
|
(iii)(b) Amortization - Purchased Software |
|
|
|
|
|
|
|
|
(iv)(b) Amortization - Internally Developed Software |
|
|
|
|
|
|
|
|
(v)(b) Amortization - Trademarks |
|
|
|
|
|
|
|
|
Amortization - Capitalized Site Commissions (include amortization recognized as an offset against gross revenues) |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
(vi)(b) Amortization - Other Identifiable Intangible Assets |
|
|
|
|
|
|
|
|
(vii)(b) Amortization - Goodwill |
|
|
|
|
|
|
|
|
Depreciation and Amortization of Assets [row 59 + row 60 + row 61 + row 62 + row 63 + row 65 + row 66] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(c) Weighted Average Cost of Capital |
|
|
|
|
|
|
|
|
(d) Return [row 68 x row 57] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(e) Interest Other than Interest Paid on Customer Prepayments or Deposits |
|
|
|
|
|
|
|
|
(f) Interest Paid on Customer Prepayments or Deposits |
|
|
|
|
|
|
|
|
(g) Other Income Tax-Related Adjustments |
|
|
|
|
|
|
|
|
(h) Federal Taxable Income [row 69 - row 70 - row 72] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(i) Federal Income Tax Rate |
|
|
|
|
|
|
|
|
(j) Federal Income Tax Gross-Up Factor [row 74/(1 - row 74)] |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
|
|
|
(k) Federal Income Tax [row 75 x row 73] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(l) Federal Income Tax Not Deductible for State Income Tax Purposes |
|
|
|
|
|
|
|
|
(m) State Taxable Income [row 73 + row 77] |
0 |
0 |
0 |
0 |
0 |
|
|
|
(n) State Income Tax Rate |
|
|
|
|
|
|
|
|
(o) State Income Tax Gross-Up Factor [row 79 /(1 - row 79)] |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
|
|
|
(p) State Income Tax [row 80 x row 78] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Total Capital Expenses [row 67 + row 69 + row 71 + row 76 + row 81] |
0 |
0 |
0 |
0 |
0 |
|
|
|
3. Operating Expenses: |
|
|
|
|
|
|
|
|
(a) Maintenance, Repair, and Engineering of Site Plant, Equipment, and Facilities |
|
|
|
|
|
|
|
|
(b) Payments to Telecommunications Carriers or Other Entities for Interstate, International, or Intrastate Communications Other Than Extra Payments to Telecommunications Carriers or Other Entities for International Communications |
|
|
|
|
|
|
|
|
(c) Extra Payments to Telecommunications Carriers or Other Entities for International Communications |
|
|
|
|
|
|
|
|
(d) Field Services |
|
|
|
|
|
|
|
|
(e) Network Operations |
|
|
|
|
|
|
|
|
(f) Call Center |
|
|
|
|
|
|
|
|
(g) Data Center and Storage |
|
|
|
|
|
|
|
|
Payment of Site Commissions Recognized as an Expense or an Offset Against Gross Revenues When Paid or When the Commissions-Related Transaction Occurred |
N/A |
N/A |
N/A |
N/A |
N/A |
|
|
|
(h) Billing, Collection, Client Management, and Customer Care |
|
|
|
|
|
|
|
|
(i) Sales and Marketing |
|
|
|
|
|
|
|
|
(j) General and Administrative |
|
|
|
|
|
|
|
|
(k) Other Overhead |
|
|
|
|
|
|
|
|
(l) Taxes Other than Income Taxes |
|
|
|
|
|
|
|
|
(m) Transactions Related to Mergers and Acquisitions |
|
|
|
|
|
|
|
|
(n) Bad Debt |
|
|
|
|
|
|
|
|
Total Operating Expenses [sum of rows 84-90 + sum of rows 92-98] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Total Operating Expenses Excluding Extra Payments to Telecommunications Carriers or Other Entities for International Communications [row 99 - row 86] |
0 |
0 |
0 |
0 |
0 |
|
|
|
Annual Total Expenses for Video IPCS Excluding Extra Payments to Telecommunications Carriers or Other Entities for International Communications [row 82 + row 100] |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
D1. Facility-Specific Demand and Revenue Data for 2022 Enter Unique Contract Identifier for Facility in this row |
|
|
|
|
|
|
|
|
d. Facility-specific Demand and Revenue Data Enter Unique Facility Identifier in this row |
|
|
|
|
|
Total 2022 |
5 |
Count |
(1) Annual Demand for IPCS |
|
|
|
|
|
|
|
|
(a) Total Billed Communications for Audio IPCS |
|
|
|
|
|
|
|
|
(b) Billed Communications for Audio IPCS Separately for: |
|
|
|
|
|
|
|
|
(i) Interstate Communication |
|
|
|
|
|
|
|
|
(ii) International Communication |
|
|
|
|
|
|
|
|
(iii) Intrastate Communication |
|
|
|
|
|
|
|
|
(c) Total Unbilled Communications for Audio IPCS |
|
|
|
|
|
|
|
|
(d) Total Billed and Unbilled Communications for Audio IPCS |
|
|
|
|
|
|
|
|
(e) Total Billed Minutes for Audio IPCS |
|
|
|
|
|
|
|
|
(f) Billed Minutes for Audio IPCS Separately for: |
|
|
|
|
|
|
|
|
(i) Interstate Communication |
|
|
|
|
|
|
|
|
(ii) International Communication |
|
|
|
|
|
|
|
|
(iii) Intrastate Communication |
|
|
|
|
|
|
|
|
(g) Total Unbilled Minutes for Audio IPCS |
|
|
|
|
|
|
|
|
(h) Total Billed and Unbilled Minutes for Audio IPCS |
|
|
|
|
|
|
|
|
(i) Total Billed Communications for Video IPCS |
|
|
|
|
|
|
|
|
(j) Billed Communications for Video IPCS Separately for: |
|
|
|
|
|
|
|
|
(i) Interstate Communication |
|
|
|
|
|
|
|
|
(ii) International Communication |
|
|
|
|
|
|
|
|
(iii) Intrastate Communication |
|
|
|
|
|
|
|
|
(k) Total Unbilled Communications for Video IPCS |
|
|
|
|
|
|
|
|
(l) Total Billed and Unbilled Communications for Video IPCS |
|
|
|
|
|
|
|
|
(m) Total Billed Minutes for Video IPCS |
|
|
|
|
|
|
|
|
(n) Billed Minutes for Video IPCS Separately for: |
|
|
|
|
|
|
|
|
(i) Interstate Communication |
|
|
|
|
|
|
|
|
(ii) International Communication |
|
|
|
|
|
|
|
|
(iii) Intrastate Communication |
|
|
|
|
|
|
|
|
(o) Total Unbilled Minutes for Video IPCS |
|
|
|
|
|
|
|
|
(p) Total Billed and Unbilled Minutes for Video IPCS |
|
|
|
|
|
|
|
|
(q) Total Billed Video IPCS Sales Units Other than Discrete Communications or Minutes - (identify other units here) |
|
|
|
|
|
|
|
|
(r) Billed Video IPCS Sales Units Other than Discrete Communications or Minutes - (identify other units here) - Separately for: |
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(i) Interstate Communication |
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(ii) International Communication |
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(iii) Intrastate Communication |
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(s) Total Unbilled Video IPCS Sales Units Other than Discrete Communications or Minutes - (identify other units here) |
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(t) Total Billed and Unbilled Video IPCS Sales Units Other than Discrete Communications or Minutes - (identify other units here) |
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(u) Average Daily Population |
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(v) Total Number of IPCS Accounts Opened |
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(w) Total Number of IPCS Accounts Closed |
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(x) Total Admissions (optional) |
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(y) Total Releases (optional) |
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(z) Weekly Turnover Rate (optional) |
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(aa) Number of Incarcerated People’s Tablets |
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(bb) Number of Incarcerated People’s Kiosks |
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(cc) Number of Other Devices Used by Incarcerated People to Access IPCS |
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(2) Annual Demand for Automated Payment Service, Live Agent Service, Paper Bill/Statement Service, Single-Call and Related Services, and Third-Party Financial Transaction Service |
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Billed Uses of Automated Payment Service |
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Billed Uses of Live Agent Service |
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Billed Uses of Paper Bill/Statement Service |
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Billed Transactions for Single-Call and Related Services |
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Billed Transactions for Third-Party Financial Transaction Service |
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(3) Annual Revenues from IPCS |
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(a) Total Billed Revenues from Audio IPCS |
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0 |
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(b) Billed Revenues from Audio IPCS Separately for: |
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(i) Interstate Communication |
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(ii) International Communication |
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(iii) Intrastate Communication |
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(c) Total Billed Revenues from Video IPCS |
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0 |
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(d) Billed Revenues from Video IPCS Separately for: |
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(i) Interstate Communication |
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(ii) International Communication |
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(iii) Intrastate Communication |
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(4) Annual Revenues from Automated Payment Service, Live Agent Service, Paper Bill/Statement Service, Single-Call and Related Services, and Third-Party Financial Transaction Service |
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Revenues from Automated Payment Service |
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Revenues from Live Agent Service |
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Revenues from Paper Bill/Statement Service |
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Revenues from Single-Call and Related Services |
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Revenues from Third-Party Financial Transaction Service |
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Total Revenues from Ancillary Services (sum of rows 66 through 70) |
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0 |
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D2.b. Facility-Specific Site Commissions for 2022 Enter Unique Contract Identifier for Facility in this row |
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Enter Unique Facility Identifier in this row |
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Total |
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b. Site Commissions |
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5 |
Count |
(1) Total Site Commissions: The total amount of all Site Commissions paid by the Company during 2022 that was related to the Facility |
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0 |
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(a) Percentage of Total Site Commissions paid by the Company during 2022 that was related to the Facility and that was attributable to the Company’s provision of IPCS and associated Ancillary Services |
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(b) Percentage of Total Site Commissions paid by the Company during 2022 that was related to the Facility and that was attributable to the Company’s provision of Safety and Security Measures |
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(c) List the Other Products and Services and associated Ancillary Services that the Company provided at the Facility during 2022 |
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(d) - (e) Word template entry |
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(2) Legally Mandated Site Commissions: The total amount of Legally Mandated Site Commissions paid in connection with IPCS and associated Ancillary Services provided at the Facility during 2022. |
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0 |
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(a) Recipient: Name of the entity or entities to which the Company paid Legally Mandated Site Commissions during 2022 in connection with the Company’s IPCS or associated Ancillary Services provided at the Facility. Allocate the payment among the relevant entities. |
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(b) Legally Mandated Site Commission Authority: If the Company paid Legally Mandated Site Commissions in connection with IPCS or associated Ancillary Services provided at the Facility during 2022, provide a citation to the authority requiring such payment. |
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(c) Total Monetary Site Commissions: Total amount of Legally Mandated, Monetary Site Commissions paid during 2022 in connection with IPCS and associated Ancillary Services provided at the Facility |
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0 |
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|
(d) Recipient: Name of the entity or entities to which the Company paid Legally Mandated, Monetary Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payment among the relevant entities. |
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(i) Fixed Site Commissions: Total amount of Legally Mandated Site Commissions that were both Monetary Site Commissions and Fixed Site Commissions and that were paid during 2022 in connection with IPCS and associated Ancillary Services provided at the Facility |
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(aa) Recipient: Name of the entity or entities to which the Company paid Legally Mandated, Fixed, Monetary Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities |
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(ab) Allocation: If the Legally Mandated, Fixed, Monetary Site Commission was imposed at the contract level (e.g., a minimum annual guarantee due annually under a contract covering multiple Facilities), allocate the Site Commission payments among all Facilities covered by the contract |
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|
(ac) Word template entry |
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(ad) Upfront Payments: Total amount of all Legally Mandated Site Commissions for 2022 that not only were Monetary Site Commissions and Fixed Site Commissions but also were paid, at the signing of a contract or during the first year of the contract, in connection with the provision of IPCS and associated Ancillary Services provided at the Facility |
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(aaa) Recipient: Name of the entity or entities to which the Company made these upfront payments during 2022. Allocate the payments among the relevant entities. |
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|
(ii) Variable Site Commissions: Amount of Legally Mandated Site Commissions that were both Monetary Site Commissions and Variable Site Commissions and that were paid during 2022 in connection with IPCS and associated Ancillary Services provided at the Facility |
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|
|
|
|
(aa) Recipient: Name of the entity or entities to which the Company made Legally Mandated, Variable, Monetary Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities. |
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|
|
|
|
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|
|
(e) In-Kind Site Commissions: Amount of Legally Mandated Site Commissions that were also In-Kind Site Commissions and that were paid during 2022 in connection with IPCS and associated Ancillary Services provided at the Facility. |
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|
|
|
|
(i) Recipient: Name of the entity or entities to which the Company paid Legally Mandated, In-Kind Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities. |
|
|
|
|
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|
(ii) Word template entry |
|
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|
|
(iii) Fixed Site Commissions: Amount of Legally Mandated Site Commissions that were both In-Kind Site Commissions and Fixed Site Commissions and that were paid during 2022 in connection with IPCS and associated Ancillary Services provided at the Facility |
|
|
|
|
|
|
|
|
(aa) Recipient: Name of the entity or entities to which the Company paid Legally Mandated, Fixed, In-Kind Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities |
|
|
|
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|
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|
(ab) Allocate: If the Legally Mandated, Fixed, In-Kind Site Commission was imposed at the contract level (e.g., a minimum annual guarantee due annually under a contract covering multiple Facilities), allocate the Site Commission payments among all Facilities covered by the contrac |
|
|
|
|
|
|
|
|
(ac) Word template entry |
|
|
|
|
|
|
|
|
(ad) Upfront Payments: Amount of all Legally Mandated Site Commissions for 2022 that not only were In-Kind Site Commissions and Fixed Site Commissions but also were paid, at the signing of a contract or during the first year of the contract, in connection with the provision of IPCS provided at the Facility |
|
|
|
|
|
|
|
|
(aaa) Recipient: Name of the entity or entities to which the Company made these upfront payments. If those Site Commissions were paid to more than one entity, allocate the payments among the relevant entities |
|
|
|
|
|
|
|
|
(iv) Variable Site Commissions: Amount of Legally Mandated Site Commissions that were both In-Kind Site Commissions and Variable Site Commissions and that were paid during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility |
|
|
|
|
|
|
|
|
(aa) Recipient: Name of the entity or entities to which the Company paid Legally Mandated, Variable, In-Kind Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities. |
|
|
|
|
|
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|
|
(3) Total Contractually Prescribed Site Commissions: Total amount of Contractually Prescribed Site Commissions paid during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. |
|
|
|
|
|
0 |
|
|
(a) Recipient: Name of the entity or entities to which the Company paid Contractually Prescribed Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payment among the relevant entities. |
|
|
|
|
|
|
|
|
(b) Total Monetary Site Commissions: Total amount of Contractually Prescribed, Monetary Site Commissions paid by the Company during 2022 that was related to the Facility |
|
|
|
|
|
0 |
|
|
(i) Recipient: Name of the entity or entities to which the Company paid Contractually Prescribed, Monetary Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities |
|
|
|
|
|
|
|
|
(ii) Fixed Site Commissions: Amount of Contractually Prescribed Site Commissions that were both Monetary Site Commissions and Fixed Site Commissions and that were paid during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility |
|
|
|
|
|
|
|
|
(aa) Recipient: Name of the entity or entities to which the Company paid Contractually Prescribed, Fixed, Monetary Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities. |
|
|
|
|
|
|
|
|
(ab) Allocate: If the Contractually Prescribed, Fixed, Monetary Site Commission was imposed at the contract level (e.g., a minimum annual guarantee due annually under a contract covering multiple Facilities), allocate the Site Commission payments among all Facilities covered by the contract |
|
|
|
|
|
|
|
|
(ac) Word template entry |
|
|
|
|
|
|
|
|
(ad) Upfront Payments: Amount of all Contractually Prescribed Site Commissions for 2022 that not only were Monetary Site Commissions and Fixed Site Commissions but also were paid, at the signing of a contract or during the first year of the contract, in connection with the provision of IPCS provided at the Facility |
|
|
|
|
|
|
|
|
(aaa) Recipient: Name of the entity or entities to which made these upfront payments. Allocate the payments among the relevant entities |
|
|
|
|
|
|
|
|
(iii) Variable Site Commissions: Amount of Contractually Prescribed Site Commissions for 2022 that were both Monetary Site Commissions and Variable Site Commissions and that were paid in connection with IPCS or associated Ancillary Services provided at the Facility |
|
|
|
|
|
|
|
|
(aa) Recipient: Name of the entity or entities to which the Company paid Contractually Prescribed, Variable, Monetary Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities |
|
|
|
|
|
|
|
|
(c) Total In-Kind Site Commissions: Amount of Contractually Prescribed Site Commissions for 2022 that were also In-Kind Site Commissions and that were paid in connection with IPCS or associated Ancillary Services provided at the Facility |
|
|
|
|
|
|
|
|
(i) Recipient: Name of the entity or entities to which the Company paid Contractually Prescribed, In-Kind Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities. |
|
|
|
|
|
|
|
|
(ii) Word template entry |
|
|
|
|
|
|
|
|
(iii) Fixed Site Commissions: Amount of Contractually Prescribed Site Commissions for 2022 that were both In-Kind Site Commissions and Fixed Site Commissions and that were paid in connection with IPCS or associated Ancillary Services provided at the Facility |
|
|
|
|
|
|
|
|
(aa) Recipient: name of the entity or entities to which the Company paid Contractually Prescribed, Fixed, In-Kind Site Commissions during 2022 in connection with IPCS or associated Ancillary Services provided at the Facility. Allocate the payments among the relevant entities |
|
|
|
|
|
|
|
|
(ab) Allocate: If the Contractually Prescribed, Fixed, In-Kind Site Commission was imposed at the contract level (e.g., a minimum annual guarantee due annually under a contract covering multiple Facilities), allocate the Site Commission payments among all Facilities covered by the contract |
|
|
|
|
|
|
|
|
(ac) Word template entry |
|
|
|
|
|
|
|
|
(ad) Upfront Payments: Amount of all Contractually Prescribed Site Commissions for 2022 that not only were In-Kind Site Commissions and Fixed Site Commissions but also were paid, at the signing of a contract or during the first year of the contract, in connection with the provision of IPCS provided at the Facility |
|
|
|
|
|
|
|
|
(aaa) Recipient: Name of the entity or entities to which the Company made these upfront payments. Allocate the payments among the relevant entities |
|
|
|
|
|
|
|
|
(iv) Variable Site Commissions: Amount of Contractually Prescribed Site Commissions for 2022 that were both In-Kind Site Commissions and Variable Site Commissions and that were paid in connection with IPCS or associated Ancillary Services provided at the Facility |
|
|
|
|
|
|
|
|
(aa) Recipient: Name of the entity or entities to which the Company made these upfront payments. Allocate the payments among the relevant entities |
|
|
|
|
|
|
|
|
(4) - (6) Word template entry |
|
|
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|
|
D2.e. Ancillary Services Information for 2022 Enter Unique Contract Identifier for Facility in this row |
|
|
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|
|
|
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|
|
Enter Unique Facility Identifier in this row |
|
|
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|
|
Notes |
Total |
5 |
Count |
Automated Payment Service |
|
|
|
|
|
|
|
|
|
(1) Automated Payment Fee Revenues: Enter the amount of Automated Payment Fee Revenues the Accounting Entity received from Customers for the provision of Audio and Video IPCS during 2022. |
|
|
|
|
|
|
0 |
|
|
(2) Automated Payment Fees Passed Through to An Affiliate: Enter the amount of Automated Payment Fee revenues the Accounting Entity passed through to any Affiliate, other than an Affiliate that provided Audio and Video IPCS and Ancillary Services, for the provision of Audio and Video IPCS during 2022. |
|
|
|
|
|
The same question is asked in connection with Single-Call and Related Services (A11), Live Agent Service (A22), Paper Bill/Statement Service (A28), and Third-Party Financial Transaction Services (A38). |
|
|
|
(3) Affiliates Used in Providing Automated Payment Service: List each Affiliate, if any, that the Accounting Entity used in providing its Automated Payment Service at each Facility for 2022. |
|
|
|
|
|
The same question is asked in connection with Live Agent Service (A19) and Paper Bill/Statement Service (A25). |
|
|
|
(4) Third Parties Used in Providing Automated Payment Service: List each Third Party, if any, that the Accounting Entity used in providing its Automated Payment Service at each Facility for 2022 and enter the amount of Automated Pay Service for which the Company was billed by each listed Third Party at each Facility for 2022. |
|
|
|
|
|
The same question is asked in connection with Live Agent Service (A20) and Paper/Bill Statement Service (A26). |
|
|
|
(6) Payment Card Processing Revenue for Automated Payment Fees: Of the amount reported for Automated Payment Fee Revenue above, enter the amount of that revenue attributable to Payment card processing fees charged in connection with communications at each Facility during 2022. |
|
|
|
|
|
The same question is asked in connection with Third-Party Financial Transaction Service (A32). |
|
|
|
Single-Call and Related Services |
|
|
|
|
|
|
|
|
|
(7) Fees for Single-Call and Related Services: Enter the amount of Fees for Single-Call and Related Services the Accounting Entity received from Customers in connection with its provision of Audio and Video IPCS and Ancillary Services at the Facility during 2022. |
|
|
|
|
|
|
0 |
|
|
(8) Single-Call and Related Services Revenues Passed Through to An Affiliate: Enter the amount of revenues from Fees for Single-Call and Related Services passed through to any Affiliate for Audio and Video IPCS and Ancillary Services provided at the Facility during 2022. |
|
|
|
|
|
|
|
|
|
(9) Entities Charging the Accounting Entity for Billing Services: List each entity that charged the Accounting Entity for billing services for Single-Call and Related services at each Facility for 2022. Indicate whether each listed entity is a Third Party. |
|
|
|
|
|
The same question is asked in connection with Third-Party Financial Transaction Service (A33). |
|
|
|
(10) Amounts Paid to Third Parties for Billing Services: Enter the amount the Accounting Entity paid to a Third Party for billing services in connection with Single-Call and Related Services at each Facility during 2022. |
|
|
|
|
|
The same question is asked in connection with Live Agent Service (A21), Paper Bill/Statement Service (A27), and Third-Party Financial Transaction Service (A34). |
|
|
|
(11)Single-Call and Related Services Fees Passed through to Customers: Enter the amount the Accounting Entity paid to Third Parties for billing services in connection with Single-Call and Related Services that the Company passed through to Customers at each Facility during 2022. |
|
|
|
|
|
The same question is asked in connection with Third-Party Financial Transaction Service (A35). |
|
|
|
(12)Amounts Paid to Other Entities for Billing Services: Enter the amount the Accounting Entity paid to entities other than Third Parties for billing services in connection with Single-Call and Related Services at each Facility during 2022. |
|
|
|
|
|
The same question is asked in connection with Third-Party Financial Transaction Service (A36). |
|
|
|
(13)Amounts Paid to Other Entities for Billing Services Passed Through to Customers: Enter the amount the Accounting Entity paid to entities other than Third Parties for billing services in connection with Single-Call and Related Services that the Company passed through to Customers at each Facility during 2022. |
|
|
|
|
|
The same question is asked in connection with Third-Party Financial Transaction Service (A37). |
|
|
|
Live Agent Service |
|
|
|
|
|
|
|
|
|
(14)Live Agent Fees: Enter the amount of Live Agent Fee revenue the Accounting Entity received from Customers in connection with its provision of audio and video IPCS and associated Ancillary Services at the Facility during 2022. |
|
|
|
|
|
|
0 |
|
|
(15)Affiliates Used to Provide Live Agent Service: List each Affiliate, if any, that the Accounting Entity used in providing its Live Agent Service at each Facility during 2022. |
|
|
|
|
|
|
|
|
|
(16)Third Parties Used to Provide Live Agent Service: List each Third Party, if any, that the Accounting Entity used in providing its Live Agent Service at each Facility during 2022. |
|
|
|
|
|
|
|
|
|
(17)Amounts Paid to Third Parties for Live Agent Service: Enter the amount the Accounting Entity paid to each listed Third Party for Live Agent Service at each Facility during 2022. |
|
|
|
|
|
|
|
|
|
(18)Live Agent Fee Revenue Paid to an Affiliate: Enter the amount of Live Agent Fee revenues the Accounting Entity paid to any Affiliate, other than an Affiliate that provided Audio and Video IPCS and Ancillary Services, for the provision of Audio and Video IPCS at the Facility during 2022. |
|
|
|
|
|
|
|
|
|
Paper Bill/Statement Service |
|
|
|
|
|
|
|
|
|
(19)Paper Bill/Statement Fee Revenue: Enter the amount of Paper Bill/Statement Fee revenue generated by communications originating in the Facility during 2022. |
|
|
|
|
|
|
0 |
|
|
(20)Affiliates Used to Provide Paper Bill/Statement Service: List each Affiliate, if any, that the Accounting Entity used in providing its Paper Bill/Statement Service at each Facility during 2022. |
|
|
|
|
|
|
|
|
|
(21)Third Parties Used to Provide Paper Bill/Statement Service: List each Third Party, if any, that the Accounting Entity used in providing its Paper Bill/Statement Service at each Facility during 2022. |
|
|
|
|
|
|
|
|
|
(22)Amounts Paid to Third Parties for Paper Bill/Statement Service: Enter the amount the Accounting Entity paid to each listed Third Party for Paper Bill/Statement Service at each Facility during 2022. |
|
|
|
|
|
|
|
|
|
(23)Paper Bill/Statement Fee Revenue Passed Through to an Affiliate: Enter the amount of Paper Bill/Statement Fee revenue passed through by the Accounting Entity to any Affiliate, other than an Affiliate that provided Audio or Video IPCS and Ancillary Services, for the provision of Audio and Video IPCS and Ancillary Services during 2022. |
|
|
|
|
|
|
|
|
|
Third-Party Financial Transaction Services |
|
|
|
|
|
|
|
|
|
(24)Third-Party Financial Transaction Fees: Enter the amount of revenue from Third-Party Financial Transaction Fees the Accounting Entity received from Customers in connection with its Audio and Video IPCS and Ancillary Services provided at the Facility during 2022. |
|
|
|
|
|
|
0 |
|
|
(25)Per-Transaction Charges for Third-Party Transactions: Enter the per-transaction fee(s) charged to an end user for transferring money or processing other financial transactions to facilitate an end user’s ability to make account payments via a Third Party, including a Third Party that is an Affiliate of the Provider. For each fee, indicate whether the Third Party receiving the payment is an Affiliate or non-Affiliate. |
|
|
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|
|
|
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|
|
(26)Payment Card Processing Revenue from Third-Party Financial Transaction Fees: Of the amount reported for Third-Party Financial Transaction Fees above, enter the amount of that revenue applicable to charging Customers for payment card processing for each Facility during 2022. |
|
|
|
|
|
|
|
|
|
(27)Entities Charging the Accounting Entity for Third-Party Financial Transaction Services: List each entity that charged the Accounting Entity for providing Third-Party Financial Transaction Services at each Facility for 2022. Indicate whether each listed entity is a Third Party. |
|
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|
|
|
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(28)Amounts Paid to Third Parties for Third-Party Financial Transaction Services: Enter the amount the Accounting Entity paid to Third Parties for Third-Party Financial Transaction Services at each Facility during 2022. |
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(29)Amounts Paid to Third Parties for Third-Party Financial Transaction Services Passed Through to Customers: Enter the amount the Accounting Entity paid to Third Parties for Third-Party Financial Transaction Services that the Company passed through to Customers at each Facility for 2022. |
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(30)Amounts Paid to Other Entities for Third-Party Financial Transaction Services: Enter the amount the Accounting Entity paid to entities other than Third Parties for Third-Party Financial Transaction Services at each Facility during 2022. |
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(31)Amounts Paid to Other Entities for Third-Party Financial Transaction Services Passed Through to Customers: Enter the amount the Accounting Entity paid to entities other than Third Parties for Third-Party Financial Transaction Services that the Company passed through to Customers at each Facility during 2022. |
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(32)Third-Party Financial Transaction Fees Paid to an Affiliate: Enter the amount of Third-Party Financial Transaction Fees paid by the Accounting Entity to any Affiliate, other than an Affiliate that provided Audio and Video IPCS and Ancillary Services, for Audio and Video IPCS and Ancillary Services provided at the Facility during 2022. |
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