Telecommunications Services Surcharge Worksheet For 911-Enhanced Emergency Reporting System - Delaware Divsion Of Revenue

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State of Delaware
TELECOMMUNICATIONS SERVICES SURCHARGE WORKSHEET FOR
Divsion of Revenue
911-ENHANCED EMERGENCY REPORTING SYSTEM
P.O. Box 2340
(Must be attached to Form LM11)
Wilmington, DE 19899-2340
A
B
C
D
E
F
NEW CASTLE
KENT
SUSSEX
TOTALS
Wirelines - Residential
1. Residential Wireline Count (Include BRI Lines.)
2. Minus:Lifeline Wireline Count
3. Reportable Wireline Count
4. Multiply Line 3 by $.60 =
5. Minus: Billing Adjustments
6. Corrected Billing
7. Minus: Uncollectables
8. Billing after Uncollectables
9. Minus: Adjustment for Refusal to pay
10. Net Billing
11. Minus: Adminstrative Costs
12. TOTAL TO BE REMITTED TO STATE:
(Line 10 minus Line 11.)
13. Amounts Earmarked for Counties
(Line 12 x .8333.)
14.
(Add amounts from each county and enter total in Column F.)
15. Amount Earmarked for State fund
(Line 12 minus Line 13.)
16.
(Add amounts from each county and enter total in Column F.)
*DE53613019999*
11/15/2012

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