Ncuc Form Rf/psp -Public Utility Regulatory Fee Report For The Quarter Ended printable pdf download

Ncuc Form Rf/psp -Public Utility Regulatory Fee Report For The Quarter Ended

NCUC FORM RF/PSP

Revised 3/07

STATE OF NORTH CAROLINA

UTILITIES COMMISSION

RALEIGH

PUBLIC UTILITY REGULATORY FEE REPORT FOR THE

QUARTER ENDED JUNE 30, 2007

(Fourth Quarter of Fiscal Year 20062007)

(Please Note Any Address Corrections)

Line

No.

Description

Amount

Total North Carolina Jurisdictional Revenues

(See instruction No. 1 on reverse)

Less revenues included on Line 1

determined to be uncollectible

Revenues subject to regulatory fee

(Line 1 minus Line 2)

Statutory regulatory fee percentage rate

0.0012

Amount of regulatory fee due

(See instruction Nos. 2 & 3 on reverse)

Check No. _______________

Checks should be SIGNED and made payable to N C Dept of Commerce/Utilities Commission

Total Number of Payphones in Operation this Quarter

CERTIFICATION

I hereby certify that the information contained in this report is true to the best of my knowledge

and belief.

Federal I.D. is now required

Authorized Signature and Title

Date

(

)

Contact Person (Print Clearly)

Telephone Number

NOTE: This report and payment of the regulatory fee are due on or before August 15, 2007.

See Instruction Nos. 5, 6, and 7 on reverse

The Public Utility Regulatory Fee is imposed pursuant to N.C. General Statute 62302.

Ncuc Form Rf/psp -Public Utility Regulatory Fee Report For The Quarter Ended