Fillable Fcc 492 - Rate-Of-Return Report printable pdf download

Fcc 492 - Rate-Of-Return Report

Download a blank fillable Fcc 492 - Rate-Of-Return Report in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Fcc 492 - Rate-Of-Return Report with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

FEDERAL COMMUNICATIONS COMMISSION

See reverse side for information

Approved by OMB

Washington, D.C. 20554

regarding public burden estimate.

3060-0355

1. Name and Address of Reporting Company

2. Reporting Period

(a) Annual Period Covered:

From:

To:

(b) Cumulative Period Covered:

From:

To:

FCC 492

RATE-OF-RETURN REPORT

(Read instructions on the Reverse Before Completing)

Dollar Amounts Shown in Thousands

(A) Interstate Access

(B) Common Line

3. Particulars

Current Year

Cumulative

Current Year

Cumulative

Current Year

Cumulative

1. Total Revenues

2. Total Expenses and Taxes

3. Oper. Inc. (Net Return) (1-2)

4. Rate Base - (Avg. Net. Invest.)

5. Rate of Return (3/4) Annualized

6. FCC Ordered Refund -

Amortized for Current

Period (see Line 6 Instr.)

7. Net Return (incl. effect of

FCC Ordered Refund) (3+6)

8. Rate of Return (incl. effect of FCC

Ordered Refund) (7/4) Annualized

Switched Traffic Sensitive

3. Particulars

(D) End Office

(E) Information

(F) Local Transport

Current Year

Cumulative

Current Year

Cumulative

Current Year

Cumulative

1. Total Revenues

2. Total Expenses and Taxes

3. Oper. Inc. (Net Return) (1-2)

4. Rate Base - (Avg. Net. Invest.)

5. Rate of Return (3/4) Annualized

6. FCC Ordered Refund -

Amortized for Current

Period (see Line 6 Instr.)

7. Net Return (incl. effect of

FCC Ordered Refund) (3+6)

8. Rate of Return (incl. effect of FCC

Ordered Refund) (7/4) Annualized

4. Rates of Return for the Switched Traffic Sensitive Category

5. Multiplicative Factor Used for Annualizing Rate

►

(a) Current Year

(b) Cumulative

of Return for Cumulative Measurement Period

6. Total Out-of-Period Adjustment

►

(see Instruction K)

7. CERTIFICATION: I certify that I am the chief financial officer or the duly assigned accounting officer; that I have examined the foregoing report; that to the best

of my knowledge, information, and belief, all statements of fact contained in this report are true and this report is a correct statement of the business and affairs of

the above-named respondent in respect to each and every matter set forth therein during the specified period.

Date

Typed Name of Person Signing

Title of Person Signing

Tel. No.

Signature

WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, Section 100D, AND/OR

REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, Section 312(a)(11), AND/OR FORFEITURE (U.S. CODE, TITLE

47, Section 5030.

FCC 492 - September 2004

Clear This Page