FCC Form 499-Q, March 2001 Approved by OMB 3060-0855 Estimated Average Burden Hours Per Response: 6 Hours Telecommunications Reporting Worksheet, FCC Form 499-Q Instructions for Completing the Quarterly Worksheet for Filing Contributions to Universal Service Support Mechanisms * * * * * NOTICE TO INDIVIDUALS: Sections 54.706, 54.711, and 54.713 of the Federal Communications Commission's rules require all telecommunications carriers providing interstate telecommunications services, providers of interstate telecommunications that offer interstate telecommunications for a fee on a non-common carrier basis, and payphone providers that are aggregators to contribute to universal service and file this Telecommunications Reporting Worksheet (FCC Form 499-Q) on February 1, May 1, August 1, and November 1, each year. 47 C.F.R.  54.706, 54.711, 54.713. This collection of information stems from the Commission's authority under Section 254 of the Communications Act of 1934, as amended, 47 U.S.C.  254. The data in the Worksheet will be used to calculate contributions to the universal service support mechanisms. Selected information provided in the Worksheet will be made available to the public in a manner consistent with the Commission's rules We have estimated that each response to this collection of information will take, on average, 6.0 hours. Our estimate includes the time to read the instructions, look through existing records, gather and maintain the required data, and actually complete and review the form or response. If you have any comments on this estimate, or how we can improve the collection and reduce the burden it causes you, please write the Federal Communications Commission, AMD-PERM, Washington, D.C. 20554, Paperwork Reduction Project (3060- 0855). We also will accept your comments via the Internet if you send them to jboley@fcc.gov. Please DO NOT SEND COMPLETED WORKSHEETS TO THIS ADDRESS. Remember -- You are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid Office of Management and Budget (OMB) control number. This collection has been assigned an OMB control number of 3060-0855. The Commission is authorized under the Communications Act of 1934, as amended, to collect the information we request in this form. We will use the information that you provide to determine contribution amounts. If we believe there may be a violation or potential violation of a statute or a Commission regulation, rule, or order, your worksheet may be referred to the Federal, state, or local agency responsible for investigating, prosecuting, enforcing, or implementing the statute, rule, regulation, or order. In certain cases, the information in your worksheet may be disclosed to the Department of Justice, court, or other adjudicative body when (a) the Commission; or (b) any employee of the Commission; or (c) the United States government, is a party to a proceeding before the body or has an interest in the proceeding. If you owe a past due debt to the federal government, the taxpayer identification number (such as your employer identification number) and other information you provide also may be disclosed to the Department of the Treasury Financial Management Service, other federal agencies, and/or your employer to offset your salary, IRS tax refund, or other payments to collect that debt. The Commission also may provide this information to those agencies through the matching of computer records where authorized. With the exception of your employer identification number, if you do not provide the information we request on the worksheet, the Commission may consider you in violation of sections 1.47, 52.17, 52.32, 54.713, and 64.604 of the Commission's rules. 47 C.F.R.  1.47, 52.17, 52.32, 54.713, 64.604, and 64.1195. The foregoing Notice is required by the Privacy Act of 1974, P.L. 93-579, December 31, 1974, 5 U.S.C.  552(a)(e)(3), and the Paperwork Reduction Act of 1995, P.L. No. 104-13, 44 U.S.C.  3501, et seq. * * * * * Table of Contents I. Introduction 3 II. Filing Requirements and General Instructions 3 A. Who Must File 3 1. Universal service exception for de minimis telecommunications providers 4 2. Exception for government, broadcasters, schools and libraries 6 3. Exception for systems integrator and self providers 6 B. Filing by Legal Entity 6 C. When and Where to File 7 D. Rounding of Numbers and Negative Numbers 8 E. Obligation to File Revisions 8 F. Compliance 8 III. Specific Instructions 9 A. Block 1: Contributor Identification Information 9 B. Block 2: Contact Information 9 C. Block 3: Contributor Revenue Information 10 1. Separating revenues from other contributors to the federal universal service support mechanisms from end-user and non-telecommunications revenues information (carrier's carrier vs end user) 10 2. Column (a) - total revenues 11 3. Columns (b) and (c) - percent interstate & international 11 4. Explanation of revenue categories 12 D. Block 6: Certification 13 V. Reminders 14 Figure 1: Table to determine if a contributor meets the de minimis standard for purposes of universal service contribution 6 Figure 2: Filing schedule 7 I. Introduction As required under the Communications Act of 1934, as amended, the Commission has established procedures to finance universal service support mechanisms. To accomplish this Congressionally-directed objectives, contributions are collected from telecommunications carriers providing interstate telecommunications and certain other providers of telecommunications. This Worksheet sets forth information that the contributor must submit, so that the administrator of the universal service support mechanisms may calculate and assess contributions. II. Filing Requirements and General Instructions A. Who must file All providers of telecommunications within the United States, with very limited exceptions, must file an FCC Form 499-Q Telecommunications Reporting Worksheet if their annual contribution to the federal universal service support mechanisms is expected to exceed $10,000 for the year. For purposes of determining whether an entity provides telecommunications, please note that the term "telecommunications" means the transmission, between or among points specified by the user, of information of the user's choosing, without change in the form or content of the information as sent and received. For the purpose of filing, the term "interstate telecommunications" includes, but is not limited to, the following types of services: wireless telephony including cellular and personal communications services (PCS); paging and messaging services; dispatch services; mobile radio services; operator services; access to interexchange service; special access; wide area telecommunications services (WATS); subscriber toll-free services; 900 services; message telephone services (MTS); private line; telex; telegraph; video services; satellite services; and, resale services. Note, for example, that all incumbent and competitive local exchange carriers provide access services and, therefore, provide interstate telecommunications. Note also that entities must file this worksheet, and are subject to the universal service contribution requirement, if they offer interstate telecommunications for a fee to the public even if only a narrow or limited class of users could utilize the services. Included are entities that provide interstate telecommunications to entities other than themselves for a fee on a private, contractual basis. In addition, owners of pay telephones, sometimes referred to as "pay telephone aggregators," must file this worksheet. The following three sections list types of telecommunications providers that are not required to file the Form 499-Q. 1. Universal service exception for de minimis telecommunications providers Section 54.708 of the Commission's rules states that telecommunications carriers and telecommunications providers are not required to contribute directly to the universal service support mechanisms for a given year if their contribution for that year is less than $10,000. 47 C.F.R.  54.708. Thus, potential contributors whose contribution to the universal service support mechanisms would be de minimis under the universal service rules are not required to file the Worksheet (FCC Form 499-Q) or contribute directly to universal service. Telecommunications carriers and other telecommunications providers should complete the table contained in Figure 1 to determine whether they meet the de minimis standard. To complete Figure 1, potential filers and all affiliates must first complete block 3 of the Worksheet and enter the amounts from Line 116(b) and 116(c) in Figure 1. Telecommunications providers that do not file this worksheet because they are de minimis for purposes of universal service contributions should retain Figure 1 and documentation of their contribution base revenues for 3 calendar years after the date each worksheet is due. Figure 1: Table to determine if a contributor meets the de minimis standard for purposes of universal service contribution 1 Interstate contribution base for the quarter for filer (amount reportable on filer's Form 499-Q; Line 116(b)) $ 2 International contribution base for the quarter for filer (amount reportable on filer's Form 499-Q; Line 116(c)) $ 3 Interstate contribution base for the quarter for all affiliates* (total of amounts reportable on Form 499-Q; Line 116(b) for all affiliates of the filer) $ 4 International contribution base for the quarter for all affiliates (total of amounts reportable on Form 499-Q; Line 116(e) for all affiliates of the filer) $ 5 Consolidated interstate contribution base: Line (1) + Line (3) $ 6 Consolidated international contribution base: Line (2) + Line (4) $ 7 Total potential contribution base for filer and its affiliates: Line (5) + Line (6) $ 8 Combined interstate contribution base as a percentage of total potential contribution base: Line (5) / Line (7) % 9 Interstate contribution base for filer from Line(1) $ 10 If the amount in Line (8) is equal to or greater than 8%, enter into Line (10) the international contribution base for the filer from Line (2). If the amount on Line (8) is less than 8%, enter $0 $ 11 Contribution base for the filer for the quarter for determining contributions to universal service support mechanisms: Line (9) + Line (10) $ 12 4 13 Annualized contribution base; Line 11 multiplied by Line 12 14 Estimation factor for determining whether to file a 499-Q 0.070** 15 Estimated annual contribution: amount in Line (13) multiplied by Line (14) $ * An affiliate is a "person that (directly or indirectly) owns or controls, is owned or controlled by, or is under common ownership or control with, another person." See 47 U.S.C.  153(1). ** The estimation factor is slightly higher than the contribution factor announced for the second quarter of 2001. See Public Notice, DA 01-614. Actual contribution factors for 2001 may increase or decrease depending on quarterly changes in program costs and the contribution base. Filers whose actual contribution requirements total less than $10,000 for the calendar year will be treated as de minimis and will receive refunds, if necessary. Filers whose actual contribution requirements total $10,000 or more are required to contribute to the universal service support mechanisms and must file this worksheet. 2. Exception for government, broadcasters, schools and libraries Certain entities are explicitly exempted from contributing directly to the universal service support mechanisms and need not file this worksheet. Government entities that purchase telecommunications services in bulk on behalf of themselves, e.g., state networks for schools and libraries, are not required to file or contribute directly to universal service. Public safety and local governmental entities licensed under Subpart B of Part 90 of the Commission's rules are not required to file or contribute directly to universal service. Similarly, if an entity provides interstate telecommunications exclusively to public safety or government entities and does not offer services to others, that entity is not required to file or contribute directly to universal service. In addition, broadcasters, non-profit schools, non-profit libraries, non-profit colleges, non-profit universities, and non-profit health care providers are not required to file the worksheet or contribute directly to universal service. 3. Exception for systems integrators and self providers Systems integrators that derive less than five percent of their systems integration revenues from the resale of telecommunications are not required to file or contribute directly to universal service. Systems integrators are providers of integrated packages of services and products that may include the provision of computer capabilities, interstate telecommunications services, remote data processing services, back-office data processing, management of customer relationships with underlying carriers and vendors, provision of telecommunications and computer equipment, equipment maintenance, help desk functions, and other services and products). Entities that provide services only to themselves or to commonly owned affiliates need not file. B. Filing by Legal Entity Each legal entity that provides interstate telecommunications service for a fee, including each affiliate or subsidiary of an entity, must complete separately and file a copy of the attached Telecommunications Reporting Worksheet. Entities that have distinct articles of incorporation are separate legal entities. Entities may not file "summary" worksheets for more than one contributor. Each affiliate or subsidiary should identify their ultimate controlling parent or entity on Block 1 Line (105) -- Holding Company. C. When and Where to File Figure 2 provides the filing schedule and relevant filing addresses. If February 1, April 1, May 1, August 1, or November 1 is a holiday (as defined in Section 1.4(e)(1) of the Commission's rules), worksheets are due the next business day. Figure 2: Filing schedule When to file What to file Where to file * February 1 of each year Completed Form 499-Q containing revenue information for October 1 through December 31 of the prior calendar year Form 499 Data Collection Agent Attn: Lori Terraciano 80 South Jefferson Rd. Whippany, NJ 07981 April 1 of each year Completed Form 499-A containing revenue information for January 1 through December 31 of the prior calendar year Form 499 Data Collection Agent Attn: Lori Terraciano 80 South Jefferson Rd. Whippany, NJ 07981 May 1 of each year ** Completed Form 499-Q containing revenue information for January 1 through March 31 Form 499 Data Collection Agent Attn: Lori Terraciano 80 South Jefferson Rd. Whippany, NJ 07981 August 1 of each year Completed Form 499-Q containing revenue information for April 1 through June 30 Form 499 Data Collection Agent Attn: Lori Terraciano 80 South Jefferson Rd. Whippany, NJ 07981 November 1 of each year Completed Form 499-Q containing revenue information for July 1 through September 30 Form 499 Data Collection Agent Attn: Lori Terraciano 80 South Jefferson Rd. Whippany, NJ 07981 * Do not send universal service contributions with this worksheet or to the above address. The universal service administrator will calculate the amount of contribution due and send a bill to the billing contact person and billing address identified in Line (112) of the Form 499-Q. ** The first Form 499-Q filing should contain revenue information for January 1, 2001 through March 31, 2001 and should be filed by May 11, 2001. No extensions will be granted. D. Rounding of Numbers and Negative Numbers All information provided in the worksheet should be neatly printed in ink or typed. Please provide an original officer signature in ink in Line (120). Dollar Amounts. Reported revenues in Block 3 that are greater than a thousand dollars may be rounded to the nearest thousand dollars. Regardless of rounding, all dollar amounts must be reported in whole dollars. For example, $2,271,881.93 could be reported as $2,271,882 or as $2,272,000, but could not be reported as $2272 thousand, $2,270,000.00 or $2.272 million. Please enter $0 in any line for which the contributor had no revenues for the year. Negative Numbers. Carriers are directed to provide billed revenues without subtracting any expenses, allowances for uncollectibles or settlement payments and without making out-of-period adjustments. Therefore, do not enter negative numbers on the form. E. Obligation to File Revisions Line (124) provides check boxes to show whether the worksheet is the original filing or a revised filing for the quarter. A contributor must file a revised 499-Q worksheet if it discovers an error in the data that it reports, such as would arise if the filer discovered that it omitted or misclassified a major category of revenue. However, revised filings must be made by the filing date for the subsequent 499 filing. In general, the quarterly filings will be based on unaudited books from a point in time. Carriers need not file revisions to the Form 499-Q as a result of ordinary accounting adjustments such as out-of-period adjustments. Revenue information from the Form 499- A will be used to ensure that contributions for the whole year are based on all subject revenues for the year. Contributors should not file a revised Form 499-Q Telecommunications Reporting Worksheet to reflect mergers, acquisitions, or sales of operating units. In the event that a contributor that filed a Form 499-Q no longer exists, the successor company to the contributor's assets or operations is responsible for continuing to make payments, if any, for the funding period. F. Compliance Contributors failing to file the Telecommunications Reporting Worksheet or to pay contributions in a timely fashion may be subject to the enforcement provisions of the Communications Act and any other applicable law. In addition, contributors may be billed by the administrators for reasonable costs, including interest and administrative costs that are caused by late, inaccurate, or untruthful filing of the worksheet or overdue contributions. III. Specific Instructions A. Block 1: Contributor Identification Information Block 1 of the Telecommunications Reporting Worksheet requires identification information. Line (101) -- enter the "Filer 499 ID" number for the filing entity. This is a six digit number that formerly was assigned as the Telecommunications Relay Service (TRS) Company Code. The FCC report Carrier Locator: Interstate Service Providers, which is available on the Commission's web site at www.fcc.gov/ccb/stats, shows the Filer 499 ID for all entities that filed a Form 499-A in 2000. This code should be entered at the top of each page on the paper version of the worksheet, the cover letter, and on supporting documentation, if any. New filers are assigned Filer 499 ID numbers after a completed Form 499-A Telecommunications Reporting Worksheet is received by the data collection agent. Line (102) -- enter the legal name of the filer as it appears on articles of incorporation and other legal documents. Each legal entity must file a separate worksheet. Line (103) -- provide the Internal Revenue Service (IRS) employer identification number (EIN) for the filer. This should be the same EIN that the company uses to file federal excise taxes or income taxes, if the filer offers services subject to those taxes. The EIN is also known as the taxpayer identification number (TIN) or for individuals as the social security number (SSN). Line (104) -- provide the principal name under which the company conducts telecommunications activities. This would typically be the name that appears on customer bills, or the name used when service representatives answer customer inquiries. Line (105) -- provide the name of the contributor's holding company or controlling entity, if any. The holding company need not be a common carrier. All reporting affiliates or commonly controlled contributors should have the same name appearing in Line (106). An affiliate is a "person that (directly or indirectly) owns or controls, is owned or controlled by, or is under common ownership or control with, another person." See 47 U.S.C.  153(1). Line (106) -- provide the FCC Registration Number (FRN). The FRN is a ten digit number that includes a check-digit. The FRN is used to identify an entity within all Commission Licensing/Filing systems and Ramis (the Commission's Revenue Accounting Management Information System.) This number is assigned by CORES (the Commission Registration System) and can be obtained at https://gullfoss2.fcc.gov/cores/CoresHome.html. For assistance, contact the CORES help desk at (877) 480- 3201 or by e-mail at CORES@fcc.gov. Line (107) -- enter the complete mailing address of the corporate headquarters of the reporting entity. B. Block 2: Contact Information Lines (108-111) -- enter the name, telephone number, fax number, and e-mail address of the person who filled out the Form 499-Q. This should be a person who can provide clarifications or additional information, and, if necessary, who could serve as the first point of contact in the event that either the Commission or an administrator should choose to verify or audit information provided in the Telecommunications Reporting Worksheet. Line (112) -- provide a billing contact person name and address for administrators to send billing information for contributions to the universal service fund. Information on establishing electronic fund transfer and bills for universal service will be sent to this address unless other arrangements are made via written request. C. Block 3: Contributor Revenue Information Line (113) enter the year for which revenue information is being filed. Line (114) check the appropriate box to indicate the calendar quarter for which revenue information is being reported. Lines (115-118) contain detailed revenue data. 1. Separating Revenue from Service Provided to Other Universal Service Contributors for Resale [Line (115)] from End-User Telecommunications Revenues [Line (116)] (carrier's carrier vs. end user) In the Telecommunications Reporting Worksheet, filers must report revenues using two broad categories: (1) Revenues from other contributors to the federal universal service support mechanisms; and, (2) Revenues from all other sources. Taken together, these revenues should include all revenues billed to customers and should include all revenues on the reporting entities' books of account. For the purposes of this worksheet, revenues from other contributors to the federal universal service support mechanisms are revenues from services provided by underlying carriers to other carriers for resale and are referred to herein as "carrier's carrier revenues" or "revenues from resellers." Revenues from all other sources consist primarily of revenues from services provided to end users, referred to here as "end-user revenues." This category includes non-telecommunications revenues. For the purpose of completing Line (115), a "reseller" is a telecommunications carrier or telecommunications provider that: 1) incorporates purchased telecommunications services into its own offerings; and 2) can reasonably be expected to contribute to federal universal service support mechanisms based on revenues from those offerings. Each contributor should have documented procedures to ensure that it reports as "revenues from resellers" only revenues from entities that reasonably would be expected to contribute to support universal service. The procedures should include, but not be limited to maintaining the following information on resellers: legal name; address; name of a contact person; and phone number of the contact person. If the underlying contributor does not have independent reason to know that the entity will, in fact, resell service and contribute to the federal universal service support mechanisms, then the underlying carrier should either obtain a signed statement to that effect or report those revenues as end user revenues. Note: For the purposes of filling out this worksheet -- and for calculating contributions to the universal service support mechanisms -- certain telecommunications carriers and service providers may be exempt from contribution to the universal service support mechanisms. These exempt entities, including "international only" and "intrastate only" carriers and carriers that meet the de minimis universal service threshold, should not be treated as resellers for the purpose of reporting revenues on Line (115). That is, filers that are underlying carriers should report revenues derived from the provision of telecommunications to exempt carriers and providers (including services provided to entities that are de minimis for universal service purposes) on Lines (116). Underlying carriers must contribute to the universal service support mechanisms on the basis of such revenues. 2. Column (a) - total revenues The reporting entity must report gross revenues from all sources, including nonregulated and non- telecommunications services on Lines (115) through (117) and these must add to total gross revenues as reported on Line (118). Gross revenues should include revenues derived from the provision of interstate, international, and intrastate telecommunications and non-telecommunications services. Gross revenues consist of total revenues billed to customers during the filing period with no allowances for uncollectibles, settlements, or out-of-period adjustments. Gross billed revenues may be distinct from booked revenues. NECA pool companies should report the actual gross billed revenues (CABS Revenues) reported to the NECA pool and not settlement revenues received from the pool. Where two contributors have merged prior to filing, the successor company should report total revenues for the reporting period for all predecessor operations. The two contributors, however, should continue to report separately if each maintains separate corporate identities and continues to operate. See also Section II-E, above. Gross revenues also should include any surcharges on telecommunications services that are billed to the customer and either retained by the contributor or remitted to a non-government third party under contract. Gross revenues should exclude taxes and any surcharges that are not recorded on the company books as revenues but which instead are remitted to government bodies. Note that any charge included on the customer bill and represented to recover or collect contributions to federal or state universal service support mechanisms must be included in Line (116). Other surcharges treated as revenue should be included in the revenue categories on which the surcharges were levied. For international services, gross revenues consist of gross revenues billed by U.S. contributors with no allowances for settlement payments. International settlement receipts for foreign billed service should not be included in revenues. If you have any revenue for Lines (115) and (116), you may not omit the dollar amounts from column (a) even if 100% of the revenue is for interstate or international service. 3. Column (b) and (c) - interstate & international Columns (b) and (c) are provided to identify the part of gross revenues that arise from interstate and international service for Lines (115) and (116). Intrastate telecommunications means communications or transmission between points within the same State, Territory, or possession of the United States, or the District of Columbia. Interstate and international telecommunications means communications or transmission between a point in one State, Territory, possession of the United States or the District of Columbia and a point outside that State, Territory, possession of the United States or the District of Columbia. For example, if a prepaid calling card provider collects a fixed amount of revenue per minute of traffic, and 65 percent of minutes are interstate, then interstate revenues would include 65 percent of the end-user revenue. Similarly, if a LEC bills local measured service charges for calls that originate in one state and terminate in another, these billings should be classified as interstate even though the charges are covered by a state tariff and the revenues are included in a local service account. Note that under the Commission's rules, if over ten percent of the traffic carried over a private or WATS line is interstate, then the revenues and costs generated by the entire line are classified as interstate. In general, flat-rated unbundled network access elements should be classified according to the regulatory agency that has primary jurisdiction over the contracts. In many cases, interstate and international revenues cannot be determined directly from corporate books of account or subsidiary records. Filers that cannot derive interstate and international revenues or that cannot derive the line-by-line revenue breakdowns may provide on the worksheet good faith estimates of these figures. Information supporting good faith estimates must be made available to either the FCC or to the Universal Service Administrator upon request. For convenience, calculated interstate and international revenue amounts that are greater than one thousand dollars may be rounded to the nearest thousand dollars. Please enter zero dollars in column (b) or column (c) if, and only if, there were no interstate or international revenues for the line for the reporting period. Note that under interim guidelines, the FCC provides the following safe harbor percentages of interstate revenues associated with Line (115) and Line (116): 15% of cellular and broadband PCS telecommunications revenues 12% of paging revenues 1% of analog SMR dispatch revenues Wireless telecommunications providers that choose to avail themselves of these safe harbor percentages for interstate revenue may assume that the FCC will not find it necessary to review or question the data underlying their reported percentages. 4. Explanation of revenue categories The revenue detail provided on Lines (115) through (117) should total to total gross revenue reported on Line (118). Line (115) -- Revenue from service provided to other universal service contributors for resale. This line should contain revenue from telecommunications services provided to resellers (i.e., telecommunications revenue derived from other universal service contributors). This category comprises what is commonly-referred to as "carrier's carrier revenue." Filers may wish to consult the instructions for Form 499-A, Lines (303) through (314), when calculating this figure. Line (116) -- Universal service contribution base revenues. This line should contain end-user telecommunications revenue (i.e., telecommunications revenue derived from entities that do not contribute directly to universal service), except for revenue from international calls that both originate and terminate in foreign points. Filers may wish to consult the instructions for Form 499-A, Line (420), when calculating this figure. Line (117) -- Other revenue that should not be reported in the universal service contribution base. Filers may have revenues on their books that are not derived from telecommunications or telecommunications-related functions that should not be included in the universal service contribution base. For example, this line should contain revenue from international calls that both originate and terminate in foreign points as well as other revenues that should not be included in the universal service contribution base. In addition, this line should include information services. Information services, i.e., services offering a capability for generating, acquiring, storing, transforming, processing, retrieving, utilizing, or making available information via telecommunications, are not included in the universal service or other fund contribution bases. Information services do not include any use of any such capability for the management, control, or operation of a telecommunications system or the management of a telecommunications service. Information services also are called enhanced services because they are offered over common carrier transmission facilities used in interstate communications and employ computer processing applications that act on the format, content, code, protocol, or similar aspects of the subscriber's transmitted information; provide the subscriber additional, different, or restructured information; or involve subscriber interaction with stored information. These services are exempt from contribution requirements and should be reported in Line (117). Line (117) should also include Account 5230 -- Directory revenues -- and Account 5270 -- Carrier billing and collection revenue. Line (117) should include revenues from the sale, lease, maintenance, or insurance of customer premises equipment (CPE), inside wiring charges, inside wiring maintenance insurance, and all non-telecommunications service revenues on the reporting entity's books. Line (117) should include revenues from providing open video systems (OVS), cable leased access, and direct broadcast satellite (DBS) services. Filers may wish to consult the instructions for Form 499-A, Lines (412) and (418), when calculating this figure. Line (118) -- Gross billed revenues from all sources. This line should equal the sum of revenues by type of service reported on Lines (115) through (117). As noted above, for further detail on the types of revenues that should be reported on Lines (115) through (117), filers may wish to consult the Instructions for the Form 499-A, available at the Commission's web site (www.fcc.gov/formpage.html). D. Block 4: Certification. Line (119) -- Filers may use the box in Line (119) to request nondisclosure of the revenue information contained on the Telecommunications Reporting Worksheet. By checking this box, the officer of the company signing the worksheet certifies that the information contained on the worksheet is privileged or confidential commercial or financial information and that disclosure of such information would likely cause substantial harm to the competitive position of the company filing the worksheet. This box may be checked in lieu of submitting a separate request for confidentiality pursuant to section 0.459 of the Commission's rules. All decisions regarding disclosure of company-specific information will be made by the Commission. The Commission regularly makes publicly available the names (and Block 1 and 2 contact information) of the entities that file the Telecommunications Reporting Worksheet. Lines (120) through (123) -- An officer of the reporting entity must examine the data provided in the Telecommunications Reporting Worksheet and certify that the information provided therein is accurate. An officer is a person who occupies a position specified in the corporate by-laws (or partnership agreement), and would typically be president, vice president for operations, vice president for finance, comptroller, treasurer, or a comparable position. If the reporting entity is a sole proprietorship, the owner must sign the certification. The signature on Line (120) must be in ink. Line (124) -- Indicate whether this filing is an original filing or a revised filing. See Section II-E. V. Reminders n Is the filer affiliated with another telecommunications provider? Each legal entity must file separately. Each affiliate or subsidiary must show the same holding company name on Line (105). n Provide data for all lines that apply. Show a zero for services for which the contributor had no revenues for the filing period. n Contributors to universal service support mechanisms must make five FCC Form 499 filings each year. See Figure 2. n Wherever possible, revenue information should be taken from the contributors' financial records. n The worksheet must be signed by an officer of the reporting entity. An officer is a person who occupies a position specified in the corporate by laws (or partnership agreement), and would typically be president, vice president for operations, comptroller, treasurer, or a comparable position. n Do not mail the worksheet to the FCC. See Section II-C for filing instructions. n Note that Form 499 is one of several forms that telecommunications carriers and other providers of interstate telecommunications may need to file. Information concerning common filing requirements for such providers may be found on the Commission's web site, at www.fcc.gov/ccb/filing.pdf. If you have questions about the worksheet or the instructions, you may contact: Form 499 Telecommunications Reporting Form499@neca.org Worksheet Information (973) 560-4400 Common Carrier Bureau Industry Analysis Division (202) 418-0940 TTY (Network Services Division) (202) 418-0484 If you have questions regarding contribution amounts, billing procedures or the mechanisms, you may contact: Universal Service Administration (973) 560-4400 - FEDERAL COMMUNICATIONS COMMISSION -