Instructions For Completing Kentucky Telecommunication Relay Service And Telecommunication Access Program Fund Report

2009

Instructions for Completing Kentucky Telecommunication Relay Service and

Telecommunication Access Program Fund Report

The surcharge rate for the Kentucky Telecommunications Relay Service (“TRS”) Fund is two cents ($0.02) per access line,

collected on a monthly basis. The surcharge rate for the Kentucky Telecommunications Access Program (“TAP”) is two cents

($0.02) per access line, collected on a monthly basis. The combined surcharge is four cents ($0.04) per access line, collected

on a monthly basis. Following are instructions for completing the form and definitions of the terms on the form.

All Incumbent Local Exchange Carriers (“ILECs”), Competitive Local Exchange Carriers (‘ICLECs”), and

Wireless Providers are required to collect the surcharges from their customers on a monthly basis.

The surcharges should be collected for all local exchange access lines. Local exchange access lines are defined for this

purpose as facilities which provide access to and from the telecommunications network for toll service and for local calling with

the exception of Coin, WATS, remote call forwarding, radio common carriers, interlata foreign exchange lines, private line

services, mobile, other common carriers, and company official accounts.

The surcharges should be collected for all wireless subscribers including analog and digital cellular and PCS.

Each carrier should collect the surcharge from the customers it serves on a retail basis; wholesale accounts should not be

charged the surcharge. The combined surcharge should appear on each customer’s bill as “Kentucky T R S / l A P

Surcharge” or

a similar facsimile.

Carriers may contribute to the fund on a monthly or quarterly basis depending on the number of subscribers served. Carriers

with less than 1,000 access lines may contribute on a quarterly basis. Carriers with greater than 1,000 access lines should

continue to contribute on a monthly basis. Carriers contributing on a quarterly basis will still be required to submit separate

reports for each month but remit them to the fund on a quarterly basis. Reports are due within 15 days following the reporting

month.

Form Instructions

Please complete the carrier information at the top of the form; include company name, address, telephone/fax number, vendor

number, date report filed and month for reporting data. Please circle your company designation.

Block

Monthly Access Line Data

Line 1, this is the total number of access lines in service for the month.

Line 2, the amount of the surcharge is provided.

Line 3, this should be equal to line 1 multiplied by line 2.

Line 4, the amount of the surcharge is provided

Line 5, this should be equal to line 1 multiplied by line 4.

Signature Block

Please date and print the name and title of the company official and sign the form. A company official may be an officer,

controller or other responsible person designated to be held accountable for the information submitted on the form.

Please note the two addresses at the bottom of the form and mail within 15 days after the reporting month. Utilities failing to file

reports will be subject to penalties in accordance with KRS 278.990.

Instructions For Completing Kentucky Telecommunication Relay Service And Telecommunication Access Program Fund Report - 2009