Fcc Form 159-W - Interstate Telephone Service Provider Worksheet Page 7

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DO NOT MAIL IN THIS FORM
Approved by OMB
3060-0589
FCC FORM 159-W
INTERSTATE TELEPHONE SERVICE PROVIDER WORKSHEET
Payer Name:
Filer 499 ID (FCC Form 499-A, Line 101):
Calendar Year 2010 Revenue Information (show amounts in whole dollars)
1
Service provided by U.S. carriers that both originates and terminates in foreign
points. FCC Form 499-A, Line 412 (e)
2
Interstate end-user revenues from all telecommunications services. FCC Form 499-
A, Line 420 (d)
3
International end-user revenues from all telecommunications and IVoIP services
except international-to-international. FCC Form 499-A, Line 420 (e)
4
Total interstate and international end-user revenues (Sum of lines 1, 2 and 3)
Note: Also enter this number on Block (28A) - FCC Code 1.
5
End-user interstate mobile service monthly and activation charges. FCC Form 499-
A, Line 409 (d)
6
End-user international mobile service monthly and activation charges. FCC Form
499-A, Line 409 (e)
7
End-user interstate mobile service message charges including roaming charges but
excluding toll charges. FCC Form 499-A, Line 410 (d)
8
End-user international mobile service message charges including roaming charges
but excluding toll charges. FCC Form 499-A, Line 410 (e)
9
End-user interstate satellite service. FCC Form 499-A Line 416 (d)
10
End-user international satellite service. FCC Form 499-A Line 416 (e).
11
Surcharges on mobile and satellite services identified as recovering universal service
contributions and included in Line 403 (d) or 403 (e) on your FCC Form 499-A.
Note: You may not include surcharges applied to local or toll services, nor any
surcharges identified as intrastate surcharges.
12
Interstate and international revenues from resellers that do not contribute to USF.
FCC Form 499-A, Line 511 (b)
13
Total excluded end-user revenues. (Sum of lines 5 through 12.)
Note: Also enter this number on Block (29A) – FCC Code 2.
14
Total subject revenues. (Line 4 minus Line 13)
Also enter this number on Block (25A) – Quantity. Please round to nearest dollar.
15
Interstate telecommunications service provider fee factor
.00375
16
2011 Regulatory Fee (Line 14 times Line 15). Also enter this number on Block
Please Round to Nearest Dollar
(27A) – Total Fee. You are exempt from filing if the sum of all regulatory fees due
on Line 16 is less than $10. Note: This is only a worksheet for your records and
should not be used to accompany your payment.
FCC FORM 159-W
August 2011
7

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