Mississippi Dual Party Fund Statement Of Revenues
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1$
Person responsible for completion of this form:
Name:
Tel. No.
MAIL TO:
RANDY TEW
MISSISSIPPI PUBLIC SERVICE COMMISSION
P.O. BOX 1174
JACKSON, MISSISSIPPI 39215-1174
#
:
Check No.
$
Check issued in the amount of
capy attached)
.07c(rate) =
$
Less expenses (Itemized
.
Access lines X
.
;
Remitted
(month)
(month)
(date)
MISSISSIPPI DUAL PARTY FUND STATEMENT OF REVENUES
COMPANY
billing, collected in
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