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Telecommunications Utility Requirements Calendar Year 2007 - Public Utilities Commission Of Nevada Page 2

Telecommunication Provider

Annual Report Requirements

Calendar Year 2007

1. Report of _________________________________________________________________

(Report Exact Name of Telecommunication Provider )

DBA: __________________________________________________________________

2. Address 1: ________________________________________________________________

City, State, Zip _____________________________________________________________

NOTE: ALL future correspondence will be sent to the above address.

3. The location where any working papers supporting the annual report may be reviewed.

_________________________________________________________________

4. Please provide the following financial information for the company regardless of whether the

company had customers or provided service in Nevada:

Statement of income.

A balance sheet.

A statement of cash flows for the total operations of the telecommunication provider.

The financial statements must be prepared in accordance with generally accepted

accounting principles and based on the calendar year 2007.

5. Total Nevada gross intrastate operating revenues for the period. $____________________

6. Company’s regulatory contact who will be responding to any consumer complaints received

by the Commission.

Name: _________________________________________________________________

Phone/Fax Number: ______________________________________________________

Email Address: __________________________________________________________

CONSUMER DIVISION:

Carson City/Reno--(775) 687-6000

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Las Vegas--(702) 486-2600

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Other Areas--800-992-0900, Ext. 687-6000

Telecommunications Utility Requirements Calendar Year 2007 - Public Utilities Commission Of Nevada Page 2