Fcc Form 499-A - Telecommunications Reporting Worksheet - 2003 Page 9
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34Instructions to the Telecommunications Reporting Worksheet, Form 499-A
valid Office of Management and Budget (OMB) control number. This collection has been assigned an
OMB control number of 3060-0855.
The Commission is authorized under the Communications Act to collect the information we request on this
form. We will use the information that you provide to determine contribution amounts. If we believe there
may be a violation or potential violation of a statute or a Commission regulation, rule, or order, your
Worksheet may be referred to the Federal, state, or local agency responsible for investigating, prosecuting,
enforcing, or implementing the statute, rule, regulation, or order. In certain cases, the information in your
Worksheet may be disclosed to the Department of Justice, court, or other adjudicative body when (a) the
Commission; or (b) any employee of the Commission; or (c) the United States government, is a party to a
proceeding before the body or has an interest in the proceeding.
With the exception of your employer identification number, if you do not provide the information we
request on the Worksheet, the Commission may consider you i n violation of sections 1.47, 52.17, 52.32,
54.713, 64.604, and 64.1195 of the Commission's rules. 47 C.F.R. §§ 1.47, 52.17, 52.32, 54.713, 64.604,
and 64.1195.
The foregoing Notice is required by the Paperwork Reduction Act of 1995, P.L. No. 104-13, 44 U.S.C. §
3501, et seq.
* * * * *
Table of Contents
I.
Introduction
3
II.
Filing Requirements and General Instructions
4
A.
Who Must File
4
1.
Universal service exe mption for de minimis telecommunications providers
5
2.
Exception for government, broadcasters, schools and libraries
7
3.
Exception for systems integrators and self-providers
7
B.
Filing by Legal Entity
7
C.
When and Where to File
9
D.
Rounding of Numbers and Negative Numbers
10
E.
Obligation to File Revisions
10
F.
Compliance
11
III. Specific Instructions
11
A.
Block 1: Filer Identification Information
11
B.
Block 2: Contact Information
14
C.
Block 3 and Block 4: Filer Revenue Information
15
1.
Separating revenue from other contributors to the federal universal
service support mechanisms (Block 3) from end user and
non-telecommunications revenue (Block 4) (carrier’s carrier vs. end-user)
15
2.
Column (a) - total revenues
16
3.
Columns (b), (c), (d), and (e) - interstate & international
17
4.
Explanation of revenue categories
19
Fixed local service revenue categories
19
Mobile service
20
Toll service revenue categories
20
Instructions -- Page 2
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