Deminimus Payment Exemption Request - Puerto Rico Universal Service Fund

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PUERTO RICO UNIVERSAL SERVICE FUND
Deminimus Payment Exemption Request
FY 2002-2003
This form may be submitted to request Deminimus Exemption from reporting to the Puerto Rico Universal Service Fund
(PRUSF), in accordance with the Puerto Rico Universal Service Regulations Paragraph (27). Please use this form to
calculate and to notify the PRUSF Administrator that you fall within the Deminimus Exemption range of an annual
remittance less than $1,000.
Company Code: PR- ___________ Company Name: ______________________________________
Street Address: ____________________________________________________________________
City/State/Zip: ____________________________________________________________________
Filing Instructions
Line 1 -Enter total projected revenues for July 2002–June 2003 as reported on the 2002/2003 Carrier Remittance Worksheet.
Line 2 -The PRUSF Assessment Rate is calculated at 0.44% (0.0044) for the revenue data months of July 2002 - June 2003.
Line 3 -Multiply the amount on Line 1 by the amount on Line 2 and enter the result on Line 3.
1. Projected Fiscal Period Revenues: (July 2002 - June 2003)………. 1.
2. 2002-2003 PRUSF Assessment Rate: (July 2002 – June 2003)…….
2.
0.0044
3. Total Projected Remittance: (July 2002 – June 2003) …………….. 3.
If the amount entered on Line 10 is $1,000 or less, you may qualify for a Deminimus Exemption from the PRUSF for the Fiscal Year
(July 2002 – June 2003). At the end of the Fiscal Year, you will be required to true up your projection to actuals, to ensure you qualify
for Deminimus Exemption.
If the amount entered on Line 10 is greater than $1,000, you may elect to report on a monthly or annual basis.
Company Officer or Agent Name:
Company Officer or Agent Signature:
Date:
Please complete the entire form and submit to NECA on or before August 15, 2002.
Mail or Fax to:
PRUSF Administrator
NECA
80 South Jefferson Rd.
Whippany, NJ 07981
Phone: (973) 884-8011
Fax: (973) 599-6504

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