Form Rpd-41116 - Telecommunications Relay Service Surcharge - New Mexico Taxation And Revenue Department

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RPD-41116
State of New Mexico - Taxation and Revenue Department
REV. 07/2003
TELECOMMUNICATIONS RELAY SERVICE SURCHARGE
WHO MUST FILE THIS FORM: Every telecommunications company, including cellular service companies, providing intrastate
telephone services must assess, collect and remit the telecommunications relay service surcharge to the Taxation and Revenue
Department. Telecommunications companies should assess the surcharge of thirty-three hundredths of one percent (.33%) on
all intrastate calls* (i.e., calls that originate and terminate in New Mexico) and include the amount of the surcharge on the monthly
bills to their customers. Customers should pay the surcharge at the time of payment of the monthly bill. Telecommunications
companies should remit the surcharge to the Department on or before the twenty-fifth of the month following collection.
Receipts not subject to the surcharge. Receipts from selling a service to any other telecommunications company or provider
for resale are not subject to the surcharge. Additionally, federal law prohibits the state from imposing a surcharge on certain
receipts from providing intrastate telephone services to an Indian tribe or member thereof on that tribe's territory. Please consult
regulation 3.21.7.8 NMAC to determine whether the surcharge applies to your receipts from tribes or tribal members, and what
records you should retain to demonstrate that the surcharge does not apply. Do not include these receipts on line 1.
*Effect of Federal Mobile Telecommunications Sourcing Act on intrastate calls: Beginning August 1, 2002, in addition to
collecting the surcharge on cellular services that originate and terminate in New Mexico, cellular service companies should also
assess the surcharge on intrastate cellular services in any state provided the calls originate and terminate in the same state and
are sold to a customer whose place of primary use is in New Mexico.
See the instructions for completing and filing this form.
TELECOMMUNICATIONS RELAY SERVICE SURCHARGE
Check if amended
1.
Gross collection for
intrastate telephone
FEIN:
services and intrast-
ate mobile telecom-
1.
$
munications services
CRS:
2.
Total surcharge
REPORT PERIOD:
(line 1 x 0.0033)
2.
$
Beginning (mm-yy)
Ending (mm-yy)
Penalty
3.
$
3.
NAME:
4.
Interest
$
4.
STREET/BOX:
CITY, STATE,
5.
Total Due
ZIP:
(add lines 2, 3, and 4)
5.
$
RETURN BOTTOM PORTION WITH YOUR PAYMENT
TELECOMMUNICATIONS RELAY SERVICE SURCHARGE
Check if amended
1.
Gross collection for
intrastate telephone
FEIN:
services and intrast-
ate mobile telecom-
1.
$
munications services
CRS:
2.
Total surcharge
REPORT PERIOD:
(line 1 x 0.0033)
2.
$
Beginning (mm-yy)
Ending (mm-yy)
Penalty
3.
$
3.
NAME:
4.
Interest
$
4.
STREET/BOX:
CITY, STATE,
5.
Total Due
ZIP:
$
(add lines 2, 3, and 4)
5.
Signature _________________________________________ Date _________________ Phone __________________________________________
Mail To: Taxation & Revenue Department, P.O. Box 25123, Santa Fe, NM 87504-5123

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