Form Rt-10 - Telecommunications Infrastructure Maintenance Fees Return

Form Rt-10 - Telecommunications Infrastructure Maintenance Fees Return - 1999 Page 2

Additional Required Information

Line 7 - A “final” return means that you sold or discontinued

your business and you no longer owe telecommunications

infrastructure maintenance fees. If you answer “yes,” check the

appropriate box below.

I sold the business on __ __/__ __/__ __ __ __.

I discontinued business on __ __/__ __/__ __ __ __.

If you sold your business, write the new owner’s name and

address below:

Name

_________________________________________________

Address

________________________________________________

Number and street

__________________________________________________

City

State

ZIP

Line 11d - Please identify your “other” deductions, and write

the amount of each. If you are taking a deduction for a DCCA-

certified business enterprise, you must list the business’ name

and the amount of the deduction.

__________________________________

______________

__________________________________

______________

__________________________________

______________

__________________________________

______________

__________________________________

______________

__________________________________

______________

Total “other” deductions

______________

Write the total amount of “other” deductions on Line 11d.

RT-10 Back (R-5/99)

Form Rt-10 - Telecommunications Infrastructure Maintenance Fees Return - 1999 Page 2