Telecommunications Services Surcharge Worksheet For 911-Enhanced Emergency Reporting System - Delaware Divsion Of Revenue Page 2
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3State 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
Wirelines - Business and Wireless - Personal and Business
ENTIRE STATE
17. Wireless Line Count for Personal and Business
18. Non-Centrex Line Count (Include BRI Lines.)
19. Number of Centrex Systems with Less than 9 lines and Centrex BRI lines.
20. Add Lines 17, 18 and 19 for total count
21. Multiply Line 20 by $.60
22. Number of Lines in Centrex Systems with More than 9 lines
23. Multiply Line 22 by $.067
24. Number of Primary Rate Interface ISDN systems
25. Multiply Line 24 by $3.00 (Surcharge rate times 5)
26. Add Lines 21 and 23 and 24 for total Billable Surcharge
27. Minus: Billing Adjustments
28. Corrected Billing
29. Minus: Uncollectables
30. Billing after Uncollectables
31. Minus: Adjustment for Refusal to pay
32. Net Billing
33. Minus: Adminstrative Costs
34. TOTAL TO BE REMITTED TO STATE FUND:
(Line 32 minus Line 33.)
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36. Add amounts from Line 16 F and 35F.
(Enter on Column C and on Line 4 of Form LM11)
*DE53613029999*
11/15/2012
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