Assessment True-Up Form - Wyoming Universal Service Fund

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WYOMING UNIVERSAL SERVICE FUND
ASSESSMENT TRUE-UP FORM*
Company Reporting Code: WY
Company Name:
Address:
City, State, Zip:
TRUE-UP PERIOD: FROM:
TO:
D
F
A
B
C
E
Revenue over
Assessment over
(under) reported
Rate
(under) paid
1. Month, Year
Reported Revenue
Actual Revenue
(B - C)
(D x E)
July, 2000
$
$
$
2%
$
August, 2000
$
$
$
2%
$
September, 2000
$
$
$
2%
$
October, 2000
$
$
$
2%
$
November, 2000
$
$
$
2%
$
December, 2000
$
$
$
2%
$
January, 2001
$
$
$
2%
$
February, 2001
$
$
$
2%
$
March, 2001
$
$
$
2%
$
April, 2001
$
$
$
2%
$
May, 2001
$
$
$
2%
$
June, 2001
$
$
$
2%
$
July, 2001
$
$
$
4%
$
August, 2001
$
$
$
4%
$
September, 2001
$
$
$
4%
$
October, 2001
$
$
$
4%
$
November, 2001
$
$
$
4%
$
December, 2001
$
$
$
4%
$
2. Due from (to) Wyoming Universal Service Fund
$

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