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2009 FCC Form 499-A Telecommunications Reporting Worksheet (Reporting Calendar 2008 Revenues)

Approval by OMB

>>> Please read instructions before completing. <<<

3060-0855

Annual Filing -- due April 1, 2009

During the year, filers must refile Blocks 1, 2 and 6 if there are any changes in Lines 104 or 112. See Instructions.

Block 1: Contributor Identification Information

101 Filer 499 ID [If you don't know your number, contact the administrator at (888) 641-8722.

If you are a new filer, write "new" in this block and a Filer 499 ID will be assigned to you.]

102 Legal name of reporting entity

[Enter 9 digit number]

103 IRS employer identification number

104 Name telecommunications provider is doing business as

105 Telecommunications activities of filer [Select up to 5 boxes that best describe the reporting entity. Enter numbers starting with "1" to show the order of importance -- see directions.]

CAP/CLEC

Cellular/PCS/SMR (wireless telephony incl. by resale)

Coaxial Cable

Incumbent LEC

Interconnected VoIP

Interexchange Carrier (IXC)

Local Reseller

Operator Service Provider (OSP)

Paging & Messaging

Payphone Service Provider

Prepaid Card

Private Service Provider

Satellite Service Provider

Shared-Tenant Service Provider / Building LEC

SMR (dispatch)

Toll Reseller

Wireless Data

If Other Local, Other Mobile or Other Toll is checked,

Other Local

Other Mobile

Other Toll

describe carrier type / services provided:

106.1 Holding company name

(All affiliated companies must show the same name on this line.)

[Enter 9 digit number]

106.2 Holding company IRS employer identification number

107 FCC Registration Number (FRN) [ https://svartifoss2.fcc.gov/cores/CoresHome.html ]

[Enter 10 digit number]

[For assistance, contact the CORES help desk at 877-480-3201 or CORES@fcc.gov]

108 Management company [if filer is managed by another entity]

Street1

109 Complete mailing address of reporting entity

Street 2

corporate headquarters

Note: this address will be used for the ITSP FCC regulatory

Street 3

fee billings unless the appropriate box is checked on Line 208.

City

State

Zip (postal code)

Country if not USA

Street1

110 Complete business address for customer inquiries and

Street 2

complaints

check if same address as Line 109

Street 3

City

State

Zip (postal code)

Country if not USA

111 Telephone number for customer complaints and inquiries

(

) -

ext -

[Toll-free number if available]

112 List all trade names used in the past 3 years in providing telecommunications. Include all names by which you are known by customers.

Use an additional sheet if necessary. Each reporting entity must provide all names used for telecommunications activities.

PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. § 1001

Save time, avoid problems -- file electronically at

FCC Form 499-A

February 2009