Page 2 of 6 CT-186-E (2012)
A — NYS
B — MTA
Computation of tax
15 Estimated tax penalty
(see instructions; mark an X in the box if
............................................................
15
Form CT-222 is attached)
16 Interest on late payment
16
.............................................
(see instructions)
17 Late filing and late payment penalties
........................
17
(see instructions)
18 Balance due
(add lines 14c through 17, both columns and enter here;
.......................................
18
enter the payment amount on line A on page 1)
19 Overpayment
19
............................................................
(see instructions)
20a Overpayment credited to next year’s NYS tax ....................................
20a
20b Overpayment credited to next year’s MTA surcharge ..........................
20b
21 Refund of overpayment
21
.............
(subtract lines 20a and 20b from line 19)
22a Amount of unused tax credits to be refunded
............
22a
(see instructions)
22b Refundable tax credits to be credited to next year’s tax or surcharge ...
22b
Did you provide telecommunications services in the MCTD during this tax year?
(mark an X in the appropriate box) ..................................................................................................... Yes
No
If Yes, complete Schedule B
Were you subject to the supervision of the Department of Public Service and did you provide utility
services (gas, electricity, steam, water, or refrigeration) in the MCTD during this tax year?
(mark an X in the appropriate box) .................................................................................................... Yes
No
If Yes, complete Schedule D
Schedule A — New York State excise tax on telecommunication services (Tax Law section 186-e)
Mark an X in the appropriate box
:
(see instructions)
•
•
•
Local carrier
A
Interexchange carrier
B
Facilities-based cellular common carrier
C
Part 1 — Computation of gross charges
(see instructions)
Gross charges from:
23 Intrastate services ...........................................................................................................................
23
24 Interstate and international services that originate or terminate within New York State and are
24
charged to a service address in New York State
.......
(service address is defined in the instructions)
25 Mobile telecommunications services ..............................................................................................
25
26 Services that are ancillary to the provision of telecommunication services ....................................
26
27 Services that are provided with telecommunication services .........................................................
27
28 Equipment provided in connection with telecommunication services ............................................
28
29 Intrastate private telecommunication services ................................................................................
29
30 Interstate and international private telecommunication channels where the charges for the use
of each channel segment are separately ascertainable ............................................................
30
31 Interstate and international private telecommunication channels where the charges for the use
of each channel segment are not separately ascertainable .....................................................
31
32 Total gross charges
32
.....................................................................................
(add lines 23 through 31)
(continued)
410002120094