2000/2001 Remittance Worksheet Instructions - Kansas Universal Service Fund Page 9
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17Kansas Universal Service Fund
2000/2001 Remittance Worksheet Instructions
recently started in Kansas, enter the date the business began.
Line 21 – Company Recently Starting Business
If this is an initial filing for a company, please supply the date the company started
offering services in the state.
Section 5- Certification
Line 22- Officer Name Information
Enter date, officer name, officer signature, and officer title. The officer’s signature attests to the
accuracy of all information on this remittance worksheet.
Line 23- Contact Name Information
Enter date, contact name, contact phone, and contact title. The contact person should be able
to provide worksheet clarification and could serve as the first point of contact for the KUSF
Fund Administrator.
Line 24- Complete Contact Mailing Address
Enter the complete mailing address for the contact person. Mailings will be sent to the contact
person address unless other arrangements are made by completing Attachment B.
Worksheet Submission and Payment Method
In the bottom left margin, please take note of submission addresses.
Please see Attachment D “KUSF Payment and Worksheet Submission Information” for
additional details.
Page 9 of 16
Revised 2/00
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