Statement Of Gross Intrastate Operating Revenues Form - New York State - 2010

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Matter No. 11-00354
NEW YORK STATE
DEPARTMENT OF PUBLIC SERVICE
STATEMENT OF GROSS INTRASTATE OPERATING REVENUES
UTILITY NAME and ADDRESS
I hereby certify that the amount shown below are the NEW YORK STATE gross
Intrastate operating revenues of this utility for the period reported.
Calendar Year 2010
$
_________________________________
_________________________________
Signature
___________________________________
Notary Public
___________________________________
Title
___________________________________
Date
___________________________________
Federal ID Number
MARCH 31, 2011
Please return this form by
to:
Director of Finance & Budget
NYS Dept. of Public Service
th
Three Empire State Plaza – 16
Floor
Albany, New York 12223-1350
Failure to comply with this request could result in penalties as provided by Public Service
Law, Section 95.

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