Official Federal Forms > Federal Communications Commission (FCC)
Interstate Telephone Service Provider Worksheet 159-W - Official Federal Forms
| Interstate Telephone Service Provider Worksheet Form. This is a national form and can be used in Federal Communications Commission (FCC) . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
Approved by OMB 3060-094 9 FCC FORM 159-W INTERSTATE TELEPHONE SERVI CE PROVIDER WORKSHEET Payer Name: Filer 499 ID (FCC Form 499-A, Line 101): Calendar Year 2004 Revenue Information (show amounts in whole dollars) 1 Service provided by U.S. carriers that both originates and terminates in foreign points. FCC Form 499-A, Line 412 (e) 2 Interstate end-user revenues from all telecommunications services. FCC Form 4 99- A, Line 420 (d) 3 International end-user revenues from all telecommunications services except international-to-international. FCC Form 499-A, Line 420 (e) 4 Total end-user revenues (Sum of lines 1, 2 and 3) Also enter this number on Block (28A) - FCC Code 1. 5 End-user interstate mobile service monthly and activation charges. FCC Form 49 9- A, Line 409 (d) 6 End-user international mobile service monthly and activation charges. FCC Form 499-A, Line 409 (e) 7 End-user interstate mobile service message charges including roaming charges b ut excluding toll charges. FCC Form 499-A, Line 410 (d) 8 End-user international mobile service message charges including roaming charges but excluding toll charges. FCC Form 499-A, Line 410 (e) 9 End-user interstate satellite services. FCC Form 499-A, Line 416 (d) 10 End-user international satellite services. FCC Form 499-A, Line 416 (e) 11 Surcharges on mobile and satellite services identified as recovering universal serv ice contributions and included in Line 403 (d) or 403 (e) on your FCC Form 499-A. Note: You may not include in Block (11) universal service pass-through surcharges applied to local or toll services, nor any surcharges identified as intrastate surcharges. 12 Interstate and international revenues from resellers that do not contribute to USF . FCC Form 499-A, Line 511 (b) 13 Total excluded end-user revenues. (Sum lines 5 through 12.) Also enter this number on Block (29A) FCC Code 2. 14 Total subject revenues. (Line 4 minus Line 13) Also enter this number on Block (25A) Quantity. 15 Interstate telecommunications service provider fee factor .00243 16 2005 Regulatory Fee (Line 14 times Line 15). Also enter this number on Block (27A) Total Fee. You are exempt fromilin fg if the sum of all regulatory fees due on Line 16 is less than $10. If you file, using this form, you must also complete an FCC Form 159, andinclude a copy Form of this FCC 159-W with your filing. FCC FORM 159-W July 2005 APPROVED BY OMB 3060-0949 American LegalNet, Inc. www.USCourtForms.com
|
|||||||
