| Appendix B: In the Matter of Interstate Inmate Calling Services WC Docket No. 12-375 Annual Reporting Form - OMB Control No. 3060-1222/October 2022 |
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| FCC Form 2301(a) | ||||||||||||
| Instructions: Please read this form carefully before completing. This form is to be completed by an officer of each provider of inmate calling services (ICS). If the provider seeks confidential treatment of any information, consistent with our rules and the Protective Order in place in this proceeding, it shall identify the specific information which it claims is subject to confidential treatment. | ||||||||||||
| A. Basic Information | ||||||||||||
| (1) Provider Name: | (2) Reporting Period: | |||||||||||
| (3) Officer Name, Title: | ||||||||||||
| (4) Officer Telephone Number: | (5) Officer E-Mail Address: | |||||||||||
| (6) Total Number of Correctional Facilities Served by Provider: | ||||||||||||
| (7) Number of Prisons Served by Provider: |
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| (8) Number of Jails Served by Provider with Average Daily Population (ADP) Below 1,000: | ||||||||||||
| (9) Number of Jails Served by Provider with ADP of 1,000 or more: | ||||||||||||
| B. ICS Rates | |||||||||||||||||||||||
| Contract Information | Facility Information | (7) Intrastate Rate | (8) Interstate Rate | ||||||||||||||||||||
| (1) Contracting Party | (2) Contract Identifier | (3) Name of Facilities Covered by Contract | (4) Location of Facilities | (5) Facility Type | (6) ADP | (7)(a) Highest 15-Minute Rate | (7)(b) Highest Year-End 15-Minute Rate | (7)(c) Average Per-Minute Rate | (8)(a) Highest 15-Minute Rate | (8)(b) Highest Year-End 15-Minute Rate | (8)(c) Average Per-Minute Rate | (8)(d) Above Rate Caps | |||||||||||
| (4)(a) Facility Address | (4)(b) Geographical Coordinates | (7)(a)(i) 15-Minute Rate | (7)(a)(ii) First Minute Rate | (7)(a)(iii) Additional Minute Rate | (7)(b)(i) 15-Minute Rate | (7)(b)(ii) First Minute Rate | (7)(b)(iii) Additional Minute Rate | (8)(a)(i) Highest 15-Minute Rate | (8)(a)(ii) First Minute Rate | (8)(a)(iii) Additional Minute Rate | (8)(a)(iv) Per-Minute Facility-Related Rate | (8)(b)(i) Highest 15-Minute Rate | (8)(b)(ii) First Minute Rate | (8)(b)(iii) Additional Minute Rate | (8)(b)(iv) Per-Minute Facility-Related Rate | ||||||||
| B. International Rates | |||||||||||||||||||||||||||||
| Contract Information | Facility Information | (9) International Rate | |||||||||||||||||||||||||||
| (1) Contracting Party | (2) Contract Identifier | (3) Name of Facilities Covered by Contract | (9)(a) Domestic Portion of International Rates (Y/N) | (9)(b) Rates By International Destination | (9)(c) Above Cap International Rates (Y/N) | (9)(d) Above Cap Termination Charges (Y/N) | |||||||||||||||||||||||
| Q1 | Q2 | Q3 | Q4 | ||||||||||||||||||||||||||
| (9)(b)(i) Destination | (9)(b)(ii) Highest Per-Minute Rate | (9)(b)(ii)(1) First Minute Rate | (9)(b)(ii)(2) Additional Minute Rate | (9)(b)(iii)(1) Maximum Termination Charges | (9)(b)(iv)(1) Average Termination Charges | (9)(b)(i) Destination | (9)(b)(ii) Highest Per-Minute Rate | (9)(b)(ii)(1) First Minute Rate | (9)(b)(ii)(2) Additional Minute Rate | (9)(b)(iii)(2) Maximum Termination Charges | (9)(b)(iv)(2) Average Termination Charges | (9)(b)(i) Destination | (9)(b)(ii) Highest Per-Minute Rate | (9)(b)(ii)(1) First Minute Rate | (9)(b)(ii)(2) Additional Minute Rate | (9)(b)(iii)(3) Maximum Termination Charges | (9)(b)(iv)(3) Average Termination Charges | (9)(b)(i) Destination | (9)(b)(ii) Highest Per-Minute Rate | (9)(b)(ii)(1) First Minute Rate | (9)(b)(ii)(2) Additional Minute Rate | (9)(b)(iii)(4) Maximum Termination Charges | (9)(b)(iv)(4) Average Termination Charges | ||||||
| C. ICS Rates Above the Maximum Rates Permitted Under the Commission's Rate Cap Rules | ||||||||
| (1) Contract Identifier | (2) Name of Facilities Covered by Contract | (3) Rate Information | ||||||
| (3)(a) Applicable Period (MM/DD/YYYY) | (3)(b) Interstate Rates | (3)(c) International Rates | ||||||
| (3)(b)(i) Total Rate | (3)(b)(ii) Provider Rate | (3)(b)(iii) Facility Rate | (3)(b)(iv) Facility Rate Type | (3)(c)(i) Total Rate | (3)(c)(ii) Termination Charge | |||
| D. Ancillary Service Charges | ||||||||||||||||||||||||||||||||||||||||||||
| (1) Contract Identifier | (2) Name of Facilities Covered by Contract | (3) Ancillary Service Charges | ||||||||||||||||||||||||||||||||||||||||||
| Automated Payment Service | Live Agent Service | Paper Bill/Statement Service | Single-Call and Related Services | Third-Party Financial Transaction Services | Other Ancillary Service Charge | |||||||||||||||||||||||||||||||||||||||
| (3)(a) Billed (Y/N) | (3)(b) Jurisdiction | (3)(c) Amounts Billed for Ancillary Service Charges | 3(d) Fixed or Variable Fees | (3)(e) Number of Times Each Charge has Been Assessed | (3)(a) Billed (Y/N) | (3)(b) Jurisdiction | (3)(c) Amounts Billed for Ancillary Service Charges | 3(d) Fixed or Variable Fees | (3)(e) Number of Times Each Charge has Been Assessed | (3)(a) Billed (Y/N) | (3)(b) Jurisdiction | (3)(c) Amounts Billed for Ancillary Service Charges | 3(d) Fixed or Variable Fees | (3)(e) Number of Times Each Charge has Been Assessed | (3)(a) Billed (Y/N) | (3)(b) Jurisdiction | (3)(c) Amounts Billed for Ancillary Service Charges | 3(d) Fixed or Variable Fees | (3)(e) Number of Times Each Charge has Been Assessed | 3(f) Name of Third Party | 3(f)(1) Number of Time Each Charge has Been Passed Through | 3(f)(2) Total Amount of Charges Passed Through | 3(g) Name of Third Party | 3(g)(1) Number of Time Each Charge has Been Passed Through | 3(g)(2) Total Amount of Charges Passed Through | (3)(a) Billed (Y/N) | (3)(b) Jurisdiction | (3)(c) Amounts Billed for Ancillary Service Charges | 3(d) Fixed or Variable Fees | (3)(e) Number of Times Each Charge has Been Assessed | 3(f) Name of Third Party | 3(f)(1) Number of Time Each Charge has Been Passed Through | 3(f)(2) Total Amount of Charges Passed Through | 3(g) Name of Third Party | 3(g)(1) Number of Time Each Charge has Been Passed Through | 3(g)(2) Total Amount of Charges Passed Through | (3)(a) Billed (Y/N) | (3)(b) Jurisdiction | (3)(c) Amounts Billed for Ancillary Service Charges | 3(d) Fixed or Variable Fees | (3)(e) Number of Times Each Charge has Been Assessed | 3(f) Name of Third Party | ||
| E. Site Commissions | |||||||||||||||||||
| (1) Contract Identifier | (2) Name of Facilities Covered by Contract | Monthly Site Commission Payments | Total Site Commission Payments | ||||||||||||||||
| (3) Monthly Site Commission Payments | Legally Mandated Site Commission | Contractually Prescribed Site Commission | (4) Total Site Commission Amount Paid | ||||||||||||||||
| (3)(a) Legally Mandated Site Commission Payments | Monetary Site Commission | In-Kind Site Commission | (3)(b) Contractually Prescribed Site Commission Payments | Monetary Site Commission | In-Kind Site Commission | (4)(a) Total Fixed Site Commissions Amount Paid | (4)(b) Total Variable Site Commissions Amount Paid | ||||||||||||
| (3)(a)(i) Legally Mandated, Monetary Site Commission Payments | (3)(a)(ii) Legally Mandated, In-Kind Site Commission Payments | (3)(b)(i) Contractually Prescribed, Monetary Site Commission Payments | (3)(b)(ii) Contractually Prescribed, In-Kind Site Commission Payments | ||||||||||||||||
| (3)(a)(i)(1) Legally Mandated, Monetary, Fixed Site Commission Payments | (3)(a)(i)(2) Legally Mandated, Monetary, Variable Site Commission Payments | (3)(a)(ii)(1) Legally Mandated, In-Kind, Fixed Site Commission Payments | (3)(a)(ii)(2) Legally Mandated, In-Kind, Variable Site Commission Payments | (3)(b)(i)(1) Contractually Prescribed, Monetary, Fixed Site Commission Payments | (3)(b)(i)(2) Contractually Prescribed, Monetary, Variable Site Commission Payments | (3)(b)(ii)(1) Contractually Prescribed, In-Kind, Fixed Site Commission Payments | (3)(b)(ii)(2) Contractually Prescribed, In-Kind, Variable Site Commission Payments | ||||||||||||
| F. Disability Access | |||||||||
| (1) Contract Identifier | (2) Name of Facilities Covered By Contract | (3) Number of Disability-Related Calls | (4) Number of Dropped Disability-Related Calls | (5) Number of Complaints Regarding Problems with Disability-Related Calls | (6) TTY Ancillary Service Charges | (7) Billed TTY ASC (Yes/No) | (8) Jurisdiction | (9) Amounts Billed for Ancillary Service Charges | (10) Number of Times Each Charge has Been Assessed |
| FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT |
| We have estimated that each ICS provider’s response to Form 2301(a) (consisting of Word and Excel Templates) will take 120 hours. Our estimate includes the time to read the instructions, look through existing records, gather and maintain the required data, and complete and review the form. If you have any comments on this estimate, or on how we can improve the collection and reduce the burden it causes you, please write the Federal Communications Commission, AMD-PERM, Washington, DC 20554, Paperwork Reduction Project (3060-1222). We will also accept your comments via the Internet if you send them to [email protected]. Please DO NOT SEND COMPLETED APPLICATIONS TO THIS ADDRESS. Remember—you are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This collection has been assigned an OMB Control Number of 3060-1222. |
| THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13, OCTOBER 1, 1995, 44 U.S.C. 3507. |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |