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Form 499-Q

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Released: March 1, 2013

FCC Form 499-Q, February 2013

Approved by OMB

OMB Control Number 3060-0855

Estimated Average Burden Hours Per Response: 10 Hours



Telecommunications Reporting Worksheet, FCC Form 499-Q (2013)


Instructions for Completing the Quarterly

Worksheet for Filing Contributions

to Universal Service Support Mechanisms

* * * * *
NOTICE: Sections 54.706, 54.711, and 54.713 of the Federal Communications Commission’s rules require
all telecommunications carriers providing interstate telecommunications services, interconnected voice-
over-Internet-protocol (VoIP) providers that provide interstate telecommunications, 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 or Worksheet) 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 Sections 151(i) and 254 of the Communications Act of 1934, as amended
(Communications Act or Act), 47 U.S.C. §§ 151(i), 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, 10.0 hours.
Our estimate includes the time to read the instructions, look through existing records, gather and maintain
the required data, project growth or decline in revenues, 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 PRA@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.
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, and 64.604.
The foregoing Notice is required by the Paperwork Reduction Act of 1995, P.L. No. 104-13, 44 U.S.C. §§
3501, et seq.

* * * * *

1

Table of Contents

I.
Introduction
3
II.
Filing Requirements and General Instructions
3

A.
Who Must File
3


1.
Universal service exemption 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
9

F.
Record Keeping
9

G.
Compliance
9
III. Specific Instructions
10

A.
Block 1: Contributor Identification Information
10

B.
Block 2: Contact Information
11

C.
Block 3: Contributor Revenue Information
11


1.
Separating telecommunications revenues
11


2.
Column (a) - total revenues
12


3.
Columns (b) and (c) - percent interstate & international
14


4.
Explanation of historical revenue categories
17


5.
Projected gross billed end-user interstate and international revenues
18


6.
Projected collected end-user interstate and international revenues
18

D.
Block 4: Certification
19
IV.
Additional Information
20

A.
Reminders
20

B.
Contact Information
21
Figure 1:
Table to determine if a contributor meets the de minimis standard for purposes

of universal service contribution
5
Figure 2:
Filing schedule
7


File FCC Form 499-Q onlinehttp://forms.universalservice.org/">. http://forms.universalservice.org.

2

I.

Introduction

As required under the Communications Act of 1934, as amended,1 the Commission has established
procedures to finance universal service support mechanisms. To accomplish this Congressionally-directed
objective, contributions are collected from telecommunications carriers providing interstate
telecommunications and certain other providers of interstate telecommunications (including interconnected
VoIP providers). 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.2

II.

Filing Requirements and General Instructions


A.

Who Must File

All providers of interstate telecommunications within the United States,3 with very limited exceptions, must
file an FCC Form 499-Q Telecommunications Reporting Worksheet.4
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;5 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; resale services; frame relay, asynchronous transfer mode (ATM) and Multi-
Protocol Label Switching (MPLS); audio bridging services;6 and interconnected VoIP services.7 Note, for

1 47 U.S.C. §§ 151 et seq.
2 On March 9, 2001, the Commission modified its rules to base universal service contributions on information
reported on quarterly Telecommunications Reporting Worksheet filings, with an annual true-up based on
information reported on annual Telecommunications Reporting Worksheets. Federal-State Joint Board on
Universal Service, Petition for Reconsideration filed by AT&T
, CC Docket No. 96-45, Report and Order and Order
on Reconsideration, 16 FCC Rcd 5748 (2001) (Quarterly Reporting Order); see also 1998 Biennial Regulatory
Review -- Streamlined Contributor Reporting Requirements Associated with Administration of Telecommunications
Relay Services, North American Numbering Plan, Local Number Portability, and Universal Service Support
Mechanisms
, CC Docket No. 98-171, Report and Order, 14 FCC Rcd 16602 (1999) (Consolidated Reporting
Order
).
3 For this purpose, the United States is defined as the contiguous United States, Alaska, Hawaii, American Samoa,
Baker Island, Guam, Howland Island, Jarvis Island, Johnston Atoll, Kingman Reef, Midway Island, Navassa Island,
the Northern Mariana Islands, Palmyra, Puerto Rico, the U.S. Virgin Islands, and Wake Island.
4 Section 254(d) applies not only to “every telecommunications carrier that provides interstate telecommunications
services” but also to certain “other provider[s] of interstate telecommunications.” 47 U.S.C. § 254(d) (emphasis
added). For more information on these terms, see 47 U.S.C. §§ 153(50), (51); Federal-State Joint Board on
Universal Service
, CC Docket No. 96-45, Report and Order, 12 FCC Rcd 8776 (1997) (Universal Service Order);
Universal Service Contribution Methodology et al., WC Docket No. 06-122 et al., Report and Order and Notice of
Proposed Rulemaking, 21 FCC Rcd 7518 (2006) (2006 Contribution Methodology Reform Order).
5 See Request for Review by Waterway Communication System, LLC and Mobex Network Services, LLC of a
Decision of the Universal Service Administrator
, WC Docket No. 06-122, Order, 23 FCC Rcd 12836 (Wireline
Comp. Bur. 2008).
6 See Request for Review by InterCall, Inc. of Decision of Universal Service Administrator, CC Docket No. 96-45,
Order, 23 FCC Rcd 10731, 10737-38, para. 22 (2008), petition for reconsideration denied, Petitions for
(continued . . .)

3

example, that all incumbent and competitive local exchange carriers provide access to an interstate public
network and, therefore, provide interstate telecommunications. There are no exemptions for data or non-
voice services.
Note also that entities must file this Worksheet, and are subject to universal service contribution
requirements, 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," and interconnected VoIP
providers must file this Worksheet if they do not qualify for the de minimis exemption under the
Commission’s universal service rules.
Marketing agents (i.e., entities that market services on behalf of a telecommunications provider) are not
themselves telecommunications providers and are not required to file this Worksheet. The amounts
remitted to or retained by the marketing agent are treated as expenses of the underlying provider and may
not be deducted from underlying carrier revenues. A reseller is not a marketing agent.
The following three sections list types of telecommunications providers that are not required to file the
FCC Form 499-Q. Note that such entities are treated as end users by their underlying carriers and
therefore may be subject to pass-through charges.


1.

Universal service exemption 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 $10,000.8 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 120(b) and 120(c) in Figure 1.
Telecommunications providers that do not file this Worksheet because they are de minimis for purposes of
universal service contributions (and need not file for any other purpose) should retain Figure 1 and
documentation of their contribution base revenues nonetheless for five years and may be required to provide
it to the FCC, the FCC’s Data Collection Agent or the Universal Service Administrative Company (USAC)
upon request.9
(Continued from previous page)
Reconsideration and Clarification of the InterCall Order, WC Docket No. 06-122, CC Docket No. 96-45, Order on
Reconsideration, 28 FCC Rcd 898 (2012), appeal docketed, No. 12-1124 (D.C. Cir. 2012).
7 See 47 C.F.R. § 9.3 (defining interconnected VoIP service).
8 47 C.F.R. § 54.708.
9 See Comprehensive Review of the Universal Service Fund Management, Administration, and Oversight, WC
Docket No. 05-195, Report and Order, 22 FCC Rcd 16372, 16386-87, para. 27 (2007) (codified at 47 C.F.R. §
54.706(e)) (USF Comprehensive Review Order).

4

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 $
FCC Form 499-Q; Line 120(b))
2
International contribution base for the quarter for filer (amount reportable on
$
filer’s FCC Form 499-Q; Line 120(c))
3
Interstate contribution base for the quarter for all affiliates* (total of amounts
$
reportable on FCC Form 499-Q; Line 120(b) for all affiliates of the filer)
4
International contribution base for the quarter for all affiliates (total of amounts
$
reportable on FCC Form 499-Q; Line 120(c) 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 12%, enter into Line (10)
$
the international contribution base for the filer from Line (2). If the amount on
Line (8) is less than 12%, enter $0 (See 47 C.F.R. § 54.706(c))
11
Revenue base for the filer for the quarter for determining contributions to
$
universal service support mechanisms: Line (9) + Line (10)
12
If the projected revenues on Lines (1) and (2) include projected pass-through
$
charges for contributions to federal universal service support mechanisms,
enter the total amount of projected pass-through charges. If the projected
revenues on Lines (1) and (2) do not include any universal service pass-through
charges, enter $0.
13
Contribution base; Line (11) – Line (12)
$
14
Annualizing multiplier
4
15
Annualized contribution base; Line (13) multiplied by Line (14)

16
2013 Estimation factor for determining whether to file a 499-Q
0.162**
17
Estimated annual contribution: amount in Line (15) multiplied by Line (16)
$
*
Unless otherwise specifically provided, 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."

For this purpose, the term ‘owns’ means to own an equity interest (or the equivalent thereof) of more

than 10 percent. See 47 U.S.C. § 153(2).


**
The estimation factor is based on a contribution factor of .193, which is higher than the contribution
factor announced for any quarter of 2012, and a corresponding circularity factor of 0.161810. The
public notices announcing the quarterly contribution factors are available at
http://www.fcc.gov/encyclopedia/contribution-factor-quarterly-filings-universal-service-fund-usf-
management-support. Actual contribution factors for future quarters 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.

5




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. As explained above, these non-contributors must be treated as
end users by their underlying carriers and therefore may end up contributing indirectly as a result of pass-
through charges.


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). Legal 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, or that provides interstate
interconnected VoIP service, including each affiliate or subsidiary of an entity, must complete separately
and file a copy of the attached Telecommunications Reporting Worksheet, except as provided for below.
Entities that have distinct articles of incorporation, articles of formation or similar legal documents are
separate legal entities. Each affiliate or subsidiary should identify their ultimate controlling parent or entity
on Block 1 Line (105) -- Holding Company.
Consolidated filing will be permitted only if the filing entity certifies that all of the following conditions
are met:10
(1) A single entity oversees the management of the affiliated systems;
(2)
A single entity sends bills to customers and these bills identify a single entity (or trade
name) as the service provider, rather than identifying the individual legal entities;
(3)
All revenues are posted to a single general ledger;11
(4)
To the extent that separate revenue and expense accounts exist, they are derived from one
consolidated set of books and the consolidated filing must cover all revenues contained in
the consolidated books;

10 Federal-State Joint Board on Universal Service et al, CC Docket No. 96-45 et al., Further Notice of Proposed
Rulemaking and Report and Order, 17 FCC Rcd 3752 (2002) (2002 First Contribution Methodology Order and
FNPRM
).
11 The FCC Form 499 Filings for the consolidated filer must reflect all revenues in this general ledger.

6

(5)
Customers have a single point of contact;
(6)
The consolidated filer acknowledges that process served on the consolidated filer would
represent process served on any or all of the affiliated legal entities;
(7)
The consolidated filer agrees to document and resolve all slamming complaints that might
be served on either the filing entity or any of the affiliated legal entities;12
(8)
The consolidated filer obtains a separate FCC Registration Number (FRN) from those
assigned to its affiliated legal entities;
(9)
The consolidated filer acknowledges that its obligations with regard to universal service,
Telecommunications Relay Services, Local Number Portability, the North American
Numbering Plan, and regulatory fees will be based on the data provided in consolidated
Worksheet filings, that it bears the responsibility to satisfy those obligations, and that all
legal entities covered by the filing are jointly and severally liable for such obligations; and
(10)
The consolidated filer acknowledges that it: (A) was not insolvent on the date it undertook
to make payments on a consolidated basis or on the date of actual payments to universal
service, Telecommunications Relay Services, Local Number Portability, the North
American Numbering Plan, and regulatory fees, and did not become insolvent as a result of
such undertaking or payments; (B) was not left with unreasonably small capital as a result
of such undertaking or payments; and (C) was not left unable to pay debts as they matured
as a result of such undertaking or payments.13
Each year, entities choosing to file on a consolidated basis must file a statement with the Commission’s
Data Collection Agent certifying that they meet all of the above conditions.14 Such certification also must
include: (1) a list of the legal names of all legal entities that are covered by the filing; (2) the FCC Form
499 identification numbers of all legal entities that are covered by the filing; (3) the consolidated filer’s
FRN; and (4) for wireless carriers, a list of all radio licenses (call signs) issued to each legal entity
covered by the filing. Consolidated filers should file this certification with the Commission’s Data
Collection Agent (see address in Figure 2). Furthermore, a contributor choosing to file on a consolidated
basis should recognize that any penalties associated with failure to pay or with underpayment of any of its
obligations will be assessed on the total revenue reported on the consolidated basis, rather than on a
separate legal entity basis.
C.

When and Where to File

Figure 2 provides the filing schedule and relevant filing addresses. If a filing date is a holiday (as defined in
Section 1.4(e)(1) of the Commission's rules), Worksheets are due the next business day. There is no fee to
file this form.






12 A Commercial Mobile Radio Service (CMRS) carrier that is not subject to certain slamming regulations is not
required to certify that it will document and resolve all slamming complaints that might be served on either the filing
entity or any of its affiliated legal entities that also are not subject to the slamming regulations.
13 For purposes of this certification, the term "insolvent" means either unable to pay debts when due or having
liabilities greater than assets. See 11 U.S.C. § 101(32).
14 See address in Figure 2 (Filing Schedule).

7

Figure 2: Filing schedule

What to file

When to file

Where to file **

Completed FCC Form
April 1
Data Collection Agent
499-A
c/o Universal Service Administrative Company
http://forms.universalservice.org/">http://forms.universalservice.org
Completed FCC Form
February 1
Data Collection Agent
499-Q (universal service May 1
c/o Universal Service Administrative Company
contributors only) *
August 1
http://forms.universalservice.org/">http://forms.universalservice.org
November 1
Traffic studies relied on
February 1
File one copy with:
by providers to report
May 1
Data Collection Action
interstate revenues on
August 1
c/o Universal Service Administrative Company
FCC Form 499-Q
November 1
form499@usac.org

AND

See section III.C.3 for
File one copy with:
format and content
Chief, Industry Analysis and Technology Division
requirements for traffic
Wireline Competition Bureau
studies
Federal Communications Commission
Room 6-A224, 445 12th Street, S.W.
Washington, D.C. 20554
Consolidated filer
April 1
Data Collection Agent
certification
c/o Universal Service Administrative Company

form499@usac.org
See section II.B for
format and content
requirements for
consolidated filer
certification
* February 1: FCC Form 499-Q containing revenue information for October 1 through December 31 of
the prior calendar year and projections for April 1 through June 30.
May 1: FCC Form 499-Q containing revenue information for January 1 through March 31 and
projections for July 1 through September 30.
August 1: FCC Form 499-Q containing revenue information for April 1 through June 30 and
projections for October 1 through December 31.
November 1: FCC Form 499-Q containing revenue information for July 1 through September 30 and
projections for January 1 through March 31 of the coming year.
** 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 FCC Form 499-Q.
For information on filing electronically, go to http://www.usac.org/cont/499/default.aspx
Filers may also file FCC Form 499-A, FCC Form 499-Q, consolidated filer certifications, and traffic
studies by submitting paper copies to:

Form 499 Data Collection Agent c/o USAC, 2000 L Street
N.W., Suite 200, Washington, D.C. 20036

.


8


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 (122).
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 period being reported.
Negative Numbers. Contributors are directed to provide billed revenues on Lines (115) through (119)
without subtracting any expenses, allowances for uncollectibles or settlement payments and without making
out-of-period adjustments. The amount of projected uncollectibles (the difference between Line (119) and
Line (120)) cannot exceed projected billings. Therefore, do not enter negative numbers on the form.

E.

Obligation to File Revisions

Line 127 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, i.e., if the filer discovers that it omitted or misclassified a major category of revenue. However,
revised filings must be made within 45 calendar days of the original filing date. In general, the historical
revenues contained in the quarterly filings will be based on unaudited books from a point in time and the
projections will represent the filer’s expectations as of a point in time. Contributors need not file revisions to
the FCC Form 499-Q as a result of ordinary accounting adjustments such as out-of-period adjustments.
Revenue information from the FCC Form 499-A will be used to ensure that contributions for the whole year
are based on all subject revenues for the year.
Filers should not file revised revenue information to reflect mergers, acquisitions, or sales of operating units.
In the event that a filer that submitted a Form 499-Q no longer exists, the successor company to the
contributor's assets or operations is responsible for continuing to make assessed contribution or true-up
payments, if any, for the funding period and must notify the Form 499 Data Collection Agent.

F.

Record Keeping

Filers shall maintain records and documentation to justify information reported in the
Telecommunications Reporting Worksheet, including the methodology used to determine projections and
to allocate interstate revenues, for five years.15 Additionally, filers must make available all documents
and records that pertain to them, including those of contractors and consultants working on their behalf, to
the Commission’s Office of Inspector General, to the USF Administrator, and to their auditors upon
request.16 Review by the Commission or the Administrator may cover any existing corporate records, not
just those specifically maintained for the five year period.17 Entities that acquire carrier operations
through acquisition of property, consolidation, merger, etc., must maintain the records of the acquired
entity.18


15 See USF Comprehensive Review Order, 22 FCC Rcd at 16386-87, para. 27 (“These documents and records should
include without limitation the following: financial statements and supporting documentation; accounting records;
historical customer records; general ledgers; and any other relevant documentation”).
16 See id. Administrator refers to the Universal Service Administrative Company.
17 See 47 U.S.C. § 218.
18 See 47 C.F.R. § 42.1.

9


G.

Compliance

Failure to file the Telecommunications Reporting Worksheet or to pay contributions in a timely fashion may
subject entities to the enforcement provisions of the Communications Act and any other applicable law.19 In
addition, entities 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.20 Inaccurate or untruthful information contained in the Telecommunications Reporting
Worksheet may lead to prosecution under the criminal provisions of Title 18 of the United States Code.21

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 code is assigned by the Commission’s
Data Collection Agent after a company files its first FCC Form 499-A. Filer 499 IDs for current filers can
be found at http://apps.fcc.gov/cgb/form499/499a.cfm or in the FCC report Telecommunications Provider
Locator
, which is available on the Commission's web site athttp://www.fcc.gov/wcb/iatd/lec.html"> http://www.fcc.gov/wcb/iatd/lec.html. This
code should be entered at the top of any cover letter or supporting documentation. New filers are assigned
Filer 499 ID numbers after a completed FCC 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 unless affiliated entities are filing on a
consolidated basis.22

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. Consolidated filers should provide the EIN of the holding company.
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.

Lines 105 and 105.1

– use this block to provide a common identifier for all affiliated filers. Typically, this
would be the name of the filer's holding company or controlling entity, if any. The common name used by
all affiliates need not be a common carrier. All reporting affiliates or commonly controlled entities should
have the same holding company name and holding company IRS EIN appearing on Line 105 and Line
105.1.

19 In addition, pursuant to the Debt Collection Improvement Act of 1996, the Commission shall withhold action on
applications or other requests for benefits by delinquent debtors and dismiss those applications or other requests if
the delinquent debt is not paid or satisfactory arrangement for payment is not made. See 47 C.F.R. § 1.1910;
Amendment of Parts 0 and 1 of the Commission’s Rules, Implementation of the Debt Collection Improvement Act of
1996 and Adoption of Rules Governing Applications or Requests for Benefits by Delinquent Debtors
, MD Docket
No. 02-339, 19 FCC Rcd 6540 (2004).
20 See 47 C.F.R. § 54.713 (universal service); 47 C.F.R. § 64.604(c)(5)(iii)(B) (TRS); see also 47 C.F.R. § 52.17(b)
(NANPA); 47 C.F.R. § 52.32(c) (LNPA).
21 See 47 C.F.R. § 54.711.
22 See section II-B, page 6, for information on making consolidated filings.

10


Unless otherwise specifically provided, 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.”23 For this purpose, the term ‘owns’ means “to own an equity interest (or the equivalent
thereof) of more than 10 percent.”24

If the filer has no affiliates, check the appropriate box on Line 105.

Line 106

– provide the filer’s 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://fjallfoss.fcc.gov/coresWeb/publicHome.do">https://fjallfoss.fcc.gov/coresWeb/publicHome.do 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 email address of the person who filled
out the FCC 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. Email addresses must be provided if available. Email addresses, other than those for agents for
service of process, will not be shared with parties other than the Commission or the Administrator.
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

– Check the appropriate filing due date corresponding to the historical and projected revenue you
are reporting.

Lines 114-120

– Provide detailed revenue data.
1.

Separating Telecommunications Revenues from Service Provided to Other
Contributors to the Federal Universal Service Support Mechanisms for
Resale [Line (115)] from Telecommunications Revenues from Service
Provided to End Users [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 services provided for resale by other contributors to
federal universal service support mechanisms” are revenues from services provided by underlying carriers
to other entities that meet the definition of “reseller” (see below). Such revenues are referred to herein as
"carrier's carrier revenues" or "revenues from resellers." An underlying carrier also may include as
carrier's carrier revenues any international switched service revenues received from another U.S. reselling

23 See 47 U.S.C. § 153(2).
24 Id.

11

carrier where that reselling carrier is using the underlying carrier's service to refile the foreign-billed
traffic of a foreign telephone operator.
In this case, the reselling carrier must certify to the underlying carrier that it is using the resold
international switched service to handle traffic that both originates and terminates in foreign points. In
some instances, reselling carriers are themselves selling the underlying service to another reseller. In
these instances, an underlying carrier also may include as carrier’s carrier revenue any revenues received
from service provided to entities that meet the definition of “reseller.”25 Revenues from all other sources
consist primarily of revenues from services provided to end users, referred to here as "end-user revenues."
This latter category includes foreign and non-telecommunications revenues.
Revenues from Resellers -- 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 telecommunications offerings; and 2) can reasonably be expected to contribute to federal universal
service support mechanisms based on revenues from such offerings when provided to end users.
Each filer should have documented procedures to ensure that it reports as “revenues from resellers” only
revenues from entities that meet the definition of reseller. The procedures should include, but not be
limited to, maintaining the following information on resellers: Filer 499 ID; legal name; address; name of
a contact person; phone number of the contact person; and an annual certification by the reseller regarding
its reseller status.26 Filers shall provide this information to the Commission or the Administrator upon
request.
Filers that do not comply with the above procedures will be responsible for any additional universal
service assessments that result if its customers must be reclassified as end users.
Revenues from Entities Exempt from USF Contributions -- 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" providers and
providers 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 Line (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 include account set-up, connection, service restoration, termination

25 See Universal Contribution Methodology, Application for Review of Decision of the Wireline Competition Bureau
filed by Global Crossing Bandwidth, Inc., et al.
, WC Docket No. 06-122, Order, FCC 12-134, para. 12 (Nov. 5,
2012) (2012 Wholesaler-Reseller Clarification Order); Changes to the Board of Directors of the National Exchange
Carrier Association, Inc.; Federal-State Joint Board on Universal Service
, CC Docket Nos. 96-45, 97-21, Report
and Order and Second Order on Reconsideration, 12 FCC Rcd 18400, 18507 (1997) (“For this purpose, a reseller is
a telecommunications service provider that 1) incorporates purchased telecommunications services into its own
offerings and 2) can reasonably be expected to contribute to support universal service based on revenues from those
offerings”); Federal-State Joint Board on Universal Service; Request for Review of Decision of the Universal
Service Administrator by Global Crossing Bandwidth, Inc.,
CC Docket No. 96-45, Order, 24 FCC Rcd 10824,
10825-26, para. 5 (Wireline Comp. Bur. 2009).
26 For sample reseller certification language, see Telecommunications Reporting Worksheet, FCC Form 499-A,
Instructions at 23-24 (FCC Form 499-A Instructions).

12

and other non-recurring charges. These charges should be reported on the same line that the filer reports any
associated recurring revenue. For example, an early termination charge to an end user for an interstate
private line service would be reported as interstate revenue on Line 116. Deposits are not revenue. Gross
revenues should include revenues derived from the activation and 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 revenues do not include amounts that cannot be billed to customers.
Gross revenues should include collection overages and unclaimed refunds for telecommunications and
telecommunications services when not subject to escheats. Gross billed revenues may be distinct from
booked revenues. National Exchange Carrier Association (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. Entities making consolidated filings must include in their FCC Form 499 Filings all revenue
on the consolidated books of account.27
Where two contributors have merged prior to the filing date, 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.28
Where an entity obtains, through purchase, merger or transfer, the telecommunications operations or
customer base of a telecommunications provider during a quarter, the acquiring company must report all
telecommunications revenues associated with such operations or customer base including revenues billed in
the quarter prior to the date of acquisition.
Gross revenues also should include any surcharges on telecommunications services or interconnected VoIP
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). Filers should report as intrastate
revenues state universal service charges only to the extent that actual payments to state universal service
programs were recovered by pass-through charges itemized on customer bills. 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 U.S. telecommunications revenues. For common carriers providing international
telecommunications services: except in very limited circumstances, the total revenues reported on the FCC
Form 499-Q should match the total U.S. billed revenues that will be reported each year pursuant to 47
C.F.R. § 43.61. For example, if a filer receives payment from a foreign carrier for traffic that the filer
receives outside of the United States, brings into the United States, and then refiles and carries the traffic to
a foreign point, the filer would not include those settlement-like payments as revenues on the FCC Form
499-Q even though they might be reported as revenues on the Filer’s 43.61 international traffic data report.
Note that if the filer receives the traffic in the United States, then it is providing ordinary international
service from the United States to a foreign point and receipts from the originating carrier would be reported
as revenue on Line 116 (c).
Filers may report international revenues in Section 43.61 reports that are net of credits at the time the credits
are issued. For FCC Form 499 purposes, credits may be recognized only when redeemed. In Form 499

27 For additional information regarding the reporting of revenues filers should refer to the Form 499-A Instructions.
FCC Form 499-A Instructions at 15-30.
28 See also section II-E above.

13

worksheets, filers that use earned revenue to represent billed revenue may recognize credits when redeemed
but may not report negative revenues. Other filers should include credits in uncollectibles, when earned.
For international private line services, U.S. providers must report on Line 116 revenues from the U.S.
portion of the circuit to the theoretical midpoint of the circuit regardless of whether such revenues were
billed to the customer by the filer or by a partner provider in a foreign point. Revenues from circuits within
the United States that connect a customer to an international circuit should be reported as interstate.
Revenues from circuits that connect foreign points should be reported on Line 118.
For purposes of completing this Worksheet, prepaid card revenues should be recognized when end-user
customers purchase the cards. International revenues may be reported differently on the filer’s 43.61
international traffic data reports, where revenues may be based on calls actually placed.
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 services 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. Revenues from services offered under interstate tariffs, such as revenues from federal subscriber
line charges and from federally tariffed local number portability surcharges, should be identified as
interstate revenues. This includes amounts incorporated in or bundled with other local service charges.
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
revenues. Similarly, if a local exchange carrier 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. 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.29 In general, flat-rated unbundled network access elements should be
classified according to the regulatory agency that has primary jurisdiction over the contracts.
To the extent that contributors recover a non-traffic sensitive charge for the interstate portion of fixed
local exchange service or for providing interstate or interstate access service from their customers through
a subscriber line charge or access recovery charge, they must allocate those revenues to the interstate
jurisdiction, for USF contribution reporting purposes, in a manner that is consistent with their supporting
books of accounts and records.30
Amounts billed to customers to recover federal universal service contribution obligations should be
attributed as either interstate or international revenues, as appropriate, on Line 116 but may not be reported
as intrastate revenues.
Note: Where possible, filers should report their amount of total revenues that are interstate and international
by using information from their books of account and other internal data reporting systems. Where a filer

29 See Universal Service Order, 12 FCC Rcd at 9173, para. 7788776 (1997) (citing 47 C.F.R. § 36.154(a)).
30 For example, to the extent that a contributor’s tariff filing (or equivalent) indicates that a non-traffic sensitive
charge is for interstate access, then revenues for such charge (or a portion thereof) must be allocated to interstate
revenues for USF reporting purposes.

14

can determine the precise amount of revenues that it has billed for interstate and international services, it
should enter those amounts in columns (b) and (c), respectively.
If interstate and international revenues cannot be determined directly from corporate books of account or
subsidiary records, filers provide on the Worksheet good-faith estimates of these figures. Good-faith
estimates must be based on information that is current for the filing period. Information supporting good-
faith estimates must be made available to either the FCC, data collection agent, or to the 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.
Safe Harbors -- Note that the FCC provides the following safe harbor percentages of interstate wireless
revenues associated with Lines 115, 116, 119 and 120:31

37.1% of cellular and broadband PCS telecommunications revenues

12% of paging revenues

1% of analog SMR dispatch revenues
These safe harbor percentages may not be applied to universal service pass-through charges, fixed local
service revenues, or toll service charges.

All filers must report the actual amount of interstate and
international revenues for these services.

For example, toll charges for itemized calls appearing on
mobile telephone customer bills should be reported as intrastate, interstate or international based on the
origination and termination points of the calls.
The FCC provides the following safe harbor percentage of interstate interconnected VoIP revenues
associated with Line 115, 116, 119 and 120:32

64.9% of interconnected VoIP telecommunications revenues
These safe harbor percentages may not be applied to universal service pass-through charges or other fixed
local service revenues.
Wireless telecommunications providers and interconnected VoIP providers that choose to avail
themselves of these safe harbor percentages for interstate revenues may assume that the FCC will not find
it necessary to review or question the data underlying their reported percentages. All affiliated wireless
telecommunications providers and interconnected VoIP providers must make a single election, each
quarter, whether to report actual revenues or to use the current safe harbor within the same safe harbor
category.33 So, for example, if in a calendar quarter a wireless telecommunications provider reports

31 See Federal-State Joint Board on Universal Service et al., CC Docket No. 96-45 et al., Report and Order and
Second Further Notice of Proposed Rulemaking, 17 FCC Rcd 24952 (2002) (2002 Second Contribution
Methodology Order and FNPRM
); see also Federal-State Joint Board on Universal Service, CC Docket No. 96-45,
Memorandum Opinion and Order and Further Notice of Proposed Rulemaking, 13 FCC Rcd 21252, 21258-60,
paras. 11-15 (1998) (Wireless Safe Harbor Order).
32 See 2006 Contribution Methodology Reform Order at 7532-33, 7545-46, paras. 25-27, 53-55.
33 See Federal-State Joint Board on Universal Service et al., CC Docket No. 96-45 et al., Order and Order on
Reconsideration, 18 FCC Rcd 1421, 1424-25, para. 6 (2003) (“wireless telecommunications providers are
‘affiliated’ for purposes of making the single election whether to report actual interstate telecommunications
revenues or use the applicable interim wireless safe harbor if one entity (1) directly or indirectly controls or has the
power to control another, (2) is directly or indirectly controlled by another, (3) is directly or indirectly controlled by
a third party or parties that also controls or has the power to control another, or (4) has an ‘identity of interest’ with
another contributor”). See also 47 C.F.R. § 1.2110(c)(5).

15

actual interstate revenues for its cellular and broadband PCS telecommunications services, all of its
affiliated legal entities must also report actual interstate telecommunications revenues for cellular and
broadband PCS offerings. The same wireless telecommunications provider and all affiliates, however,
could use the safe harbor for paging services.
Note: Filers should use the same methodology (traffic study or safe harbor) to report interstate and
international jurisdictions on the FCC Form 499-A as used on the FCC Form 499-Qs to forecast revenue
in each quarter of the applicable calendar year. For example, if a filer projected revenue based on a safe
harbor for the first two quarters and based on traffic studies for the final two quarters, the amounts
reported in the FCC Form 499-A for the first two quarters would be based on actual billings for those
quarters and the relevant safe harbors, and the amounts reported for the final two quarters would be based
on actual billings for those quarters and the traffic studies for those quarters.
Many carriers and other providers of telecommunications now offer packages that bundle fixed local
exchange service with interstate toll service (i.e., voice long distance) for a single price. Revenues for the
whole bundle, except for tariffed subscriber line and PICC charges, should be reported on Line 116, as
described more fully below. The portion of revenues associated with interstate and international toll
services must be identified in columns (d) and (e), respectively.34 Filers should make a good faith
estimate of the amounts of interstate and international revenues from bundled local/toll service if they
cannot otherwise determine these amounts from corporate records, and must make their methodology
available to the Commission or the Administrator, upon request.
Interconnected VoIP and CMRS providers may rely on traffic studies if they are unable to determine their
actual interstate and international revenues.35 In developing their traffic studies, interconnected VoIP and
CMRS providers may rely on statistical sampling to estimate the proportion of minutes that are interstate
and international. Any revenues associated with charges on customer bills that are identified as interstate
or international must effectively be accounted for (e.g., through proper weighting in a traffic study) as 100
percent interstate or international when reporting revenues.36 Sampling techniques must be designed to
produce a margin of error of no more than one percent with a confidence level of 95%. If the sampling
technique does not employ a completely random sample (e.g., if stratified samples are used), then the
respondent must document the sampling technique and explain why it does not result in a biased sample.
Traffic studies should include, at a minimum: (1) an explanation of the sampling and estimation methods
employed and (2) an explanation as to why the study results in an unbiased estimate with the accuracy
specified above. Mobile wireless providers and interconnected VoIP providers should retain all data
underlying their traffic studies as well as all documentation necessary to facilitate an audit of the study
data and be prepared to make this data and documentation available to the Commission upon request. In

34 See Universal Service Contribution Methodology, Petition for Declaratory Ruling of CTIA – The Wireless
Association on Universal Service Contribution Obligations, Petition for Declaratory Ruling of Cingular Wireless,
LLC
, WC Docket No. 06-122, Declaratory Order, 23 FCC Rcd 1411, 1414, para. 5 (2008) (defining “toll service”)
(Separately Stated Toll Order).
35 See 2006 Contribution Methodology Reform Order, 21 FCC Rcd at 7534-36, 7547, paras. 29-33, 57; see also
Policy and Rules Concerning the Interstate, Interexchange Marketplace; Implementation of Section 254(g) of the
Communications Act of 1934, as Amended; 1998 Biennial Regulatory Review – Review of Customer Premises
Equipment and Enhanced Services Unbundling Rules in the Interexchange, Exchange Access and Local Exchange
Markets
, CC Docket Nos. 96-61, 98-183, Report and Order, 16 FCC Rcd 7418, 7446-48, paras. 47-51 (2001) (CPE
Bundling Order
).
36 See Separately Stated Toll Order, 23 FCC Rcd at 1418, para. 15. In developing traffic studies, toll service traffic
must be identified and treated in a manner that recognizes that such traffic is more likely to be interstate or
international than intrastate. See id. Additionally, appropriate weighting of the higher revenue that is often
associated with toll service must be reflected in the traffic study or studies. See id.

16

addition, CMRS and interconnected VoIP providers that rely on traffic studies must submit those studies to
the Commission and USAC (see Figure 2 for filing instructions – including address for filing traffic
studies, and filing deadlines). To enable USAC and the FCC to match traffic studies filed by contributors
with their FCC Form 499 filings, please include the following identifying information at the top of each
page of the traffic study: Filer ID; Company Name; Holding Company (where applicable).


4.

Explanation of historical revenue categories

Total gross revenue reported on Line 118 should equal the total of the detail amounts reported on Lines 115
through 117.

Line 114

– Use this line to indicate if filer is using safe harbors to allocate revenues (in Lines 119 and 120)
between interstate and intrastate jurisdictions. Select all that apply. See instructions above for the use of
safe harbors.

Line 115

– Revenues from services provided to other universal service contributors for resale. This line
should contain revenues 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 revenues.” Filers may wish to consult the instructions for FCC 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 revenues (i.e., telecommunications revenues 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 should consult the instructions for FCC Form 499-A, Line 420, when calculating this
figure.

Line 117

– Other revenue that should not be reported in the universal service contribution base. This line
should contain revenue from international calls that both originate and terminate in foreign points and
revenues that are reportable on FCC Form 499-A, Line 418.
Line 117 should include all non-telecommunications service revenues on the reporting entity's books as
well as some revenues that are derived from telecommunications-related functions but that should not be
included in the universal service or other fund contribution bases. For example, information 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 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. For example, call moderation and call
transcription services are information services. These services are exempt from contribution requirements
and should be reported on Line 117. Line 117 should include revenues from published directory and
carrier billing and collection services. Line 117 should include revenues from the sale, lease, installation,
maintenance, or insurance of customer premises equipment (CPE). Line 117 should include inside wiring
charges and inside wiring maintenance insurance. Line 117 should include the sale or lease of
transmission facilities, such as dark fiber or bare transponder capacity, that are not provided as part of a
telecommunications service or as a UNE. Line 117 should include pole attachment revenues. Line 117
should include revenues from providing open video systems (OVS), cable leased access, and direct
broadcast satellite (DBS) services. Line 117 should include late payment charges and charges (penalties)
imposed by the company for customer checks returned for non-payment. Line 117 should include
revenues from telecommunications services provided in a foreign country where the traffic does not

17

transit the United States or where the carrier is providing service as a foreign carrier, i.e. a carrier licensed
in that country.
The Commission adopted two “safe harbor” methods for allocating revenue when telecommunications
and CPE/enhanced services are offered as a bundled package.37 The first option is to report revenues
from bundled telecommunications and CPE/enhanced service offerings based on the unbundled service
offering prices, with no discount from the bundled offering being allocated to telecommunications.
Alternatively, contributors may elect to treat all bundled revenues as telecommunications revenues for
purposes of determining their universal service obligations. Filers may choose to use allocation methods
other than the two described above. Filers should realize, however, that any other allocation methods
may not be considered reasonable, and will be evaluated on a case-by-case basis in an audit or
enforcement context. Prepaid calling card providers may avail themselves of the bundled service safe
harbors for separating revenue between telecommunications and information services.38

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 FCC Form 499-A, available at the Commission's web
site (www.fcc.gov/formpage.html).


5.

Projected gross billed end-user interstate and international revenues

The projection quarter is the calendar quarter that starts two months after the filing date and finishes five
months after the filing date. Line 119 should contain projected gross-billed end-user interstate and
international revenues, including any pass-through charges for federal universal service contributions.
These amounts should be the amounts that the filer anticipates reporting on Line 116, column (b) and
column (c), in the FCC Form 499-Q filing due six months after the present filing date. In order to estimate
these amounts, the filer could review the amounts they are reporting on Line 116 in the instant filing and
amounts reported in recent filings. In addition, filers could take into account general business conditions,
new contracts covering the projection period, pricing trends, marketing programs, expansion plans, and
other relevant information. Filers must develop good faith projections based on company procedures and
policies. If the filer anticipates that revenues are as likely to increase as decrease, then it may copy the
historic values from Line 116 to use as its projections for Line 119 or it could develop projections by
trending historic values from previous quarterly filings. Filers need not make projections for Line 119
column (a).


6.

Projected collected end-user interstate and international revenues

Line 120 should show the interstate and international revenues that the filer anticipates collecting from
customers during the projection quarter. For this purpose “collected end-user” revenues refers to gross-
billed end-user interstate and international telecommunications revenues, including any pass-through
charges for federal universal service contributions, less estimated uncollectibles.39 We define
uncollectibles as the percentage of interstate and international telecommunications revenues that the
contributor anticipates will not be collected from end-user customers. This percentage should be

37 CPE Bundling Order, 16 FCC Rcd 7418 at 7447-48, paras. 50-52.
38 See Regulation of Prepaid Calling Card Services, WC Docket No. 05-68, Declaratory Ruling, Report and Order,
21 FCC Rcd 7290, 7298. para. 22 (2006) (Prepaid Calling Card Services Order), vacated in part, Qwest Servs.
Corp. v. FCC
, 509 F.3d 531 (D.C. Cir. 2007).
39 Wireless Safe Harbor Order, 13 FCC Rcd at 21258-60, paras. 11-15; 2002 Second Contribution Methodology
Order and FNPRM
, 17 FCC Rcd at 24970, para. 32.

18

calculated in accordance with Generally Accepted Accounting Principles.40 Thus, uncollectibles should
represent the portion of gross billed revenues that the contributor reasonably expects will not be collected.
Filers that use the accrual method of accounting should use the percentage of billed revenues that they
recognize currently as a reserve for uncollectibles in their books of accounts. Filers that use the cash
method of accounting should base this percentage on a comparison of actual collections and billed
revenues, with the periods chosen to allow for the average delay between when services are billed and
when payments are received. The amounts shown on Line 120 should be the amounts on Line 119
reduced by the percentage of uncollectibles.
Filers will be billed based on the amounts reported on Line 120. Any revisions to these amounts must be
filed within 45 calendar days. No adjustments to billings will be made during the quarter to reflect actual
levels of billed service and actual collection rates. The Administrator will use the actual revenue data
provided by contributors on the FCC Form 499-A to perform annual true-ups to the quarterly projected
revenue data submitted by contributors during the prior calendar year.41 As necessary, the administrator
will then refund or collect from contributors any over-payments or under-payments. If the combined
quarterly projected revenues reported by a contributor are greater than those reported on its annual
revenue report (Form 499-A), then a refund will be provided to the contributor based on an average of the
two lowest contribution factors for the year. If the combined quarterly revenues reported by a contributor
are less than those reported on its annual revenue report (Form 499-A), then the administrator will collect
the difference from the contributor using an average of the two highest contribution factors from that
year.

D.

Block 4: Certification.

Line 121

– Filers may use the box in Line 121 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.42 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 122 through 126

– 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 and
that projections provided therein represent good faith estimates based on company procedures and policies.
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

40 General Accepted Accounting Principles (GAAP) encompasses the conventions, rules, and procedures necessary
to define accepted practice in the preparation of financial statements in the United States. The Financial Accounting
Standards Board (FASB) is currently the primary authority to establish GAAP for all companies. Carriers subject to
the Uniform System of Accounts would derive this figure from the amount recorded in Account 5301, Uncollectible
Revenue - Telecommunications.
41 See Telecommunications Reporting Worksheet, FCC Form 499-A, OMB 3060-0855 (FCC Form 499-A).
42 47 C.F.R. § 0.459. See also Examination of Current Policy Concerning the Treatment of Confidential Information
Submitted to the Commission
, GC Docket No. 96-55, Report and Order, 13 FCC Rcd 24816 (1998) (listing the
showings required in a request that information be withheld and stating that the Commission may defer action on such
requests until a formal request for public inspection has been made).

19

certification. The signature on Line 122 must be in ink unless you are a company officer who has
previously filed a signed paper form, in which case you may certify your form online.
Reporting entities have the opportunity to enter data, verify, submit and certify FCC Forms 499-A and
499-Q online via a web-based data entry system. Company officers, who have previously filed a signed
paper form, may certify subsequent forms online without being required to submit signed paper forms.
For those officers, an electronic signature in the signature block of each form certified by that officer will
be considered the equivalent to a handwritten signature on the form. By entering his or her electronic
signature into the signature block of each form, the officer, therefore, acknowledges that such electronic
signature certifies his or her identity and attests under penalty of perjury as to the truth and accuracy of
the information contained in each electronically signed form. Visit http://www.usac.org/cont/tools/forms
for more information and access to the online filing system.
A person who willfully makes false statements on the Worksheet can be punished by fine or imprisonment
under title 18 of the United States Code.43

Line 127

– Indicate whether this filing is an original filing or a revised filing.44

IV.

Additional Information

A.

Reminders


Filers are required to maintain records and documentation to justify information reported on the
Telecommunications Reporting Worksheet for five years. Filers also must maintain records
detailing the methodology used to determine projections reported on the Telecommunications
Reporting Worksheet. Upon request, filers may be required to provide such records and
documentation to the Commission or to the administrator.

Is the filer affiliated with another telecommunications provider? Each legal entity must file
separately unless they qualify for filing on a consolidated basis. See section II-B. Each affiliate or
subsidiary must show the same holding company name on Line 105.

For information on filing electronically, go to http://www.usac.org/cont/499/default.aspx

Provide data for all lines that apply. Show a zero for services for which the contributor had no
revenues for the filing period.

Contributors to universal service support mechanisms must make five FCC Form 499 filings each
year. See Figure 2.

Wherever possible, revenue information should be taken from the contributors' financial records.
Filers also must provide projected revenue information on Line 119 through Line 120.

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.

Do not mail the Worksheet to the FCC. See section II-C for filing instructions.

Note that FCC Form 499 is one of several forms that telecommunications carriers and other
providers of interstate telecommunications may need to file. Information concerning common

43 See 18 U.S.C. § 1001.
44 See section II-E.

20

filing requirements for such providers may be found on the FCC web site, at
http://www.fcc.gov/wcb/filing.html">www.fcc.gov/wcb/filing.html.

B.

Contact Information

If you have questions about the Worksheet or the instructions, please contact:
Universal Service Administrator
form499@usac. org


(888) 641-8722
Wireline Competition Bureau
Industry Analysis and Technology Division
(202) 418-0940


(202) 418-0484 (TTY)
If you have questions regarding contribution amounts, billing procedures, or the support and cost recovery
mechanisms, you may contact:
Universal Service Administrator
(888) 641-8722


- FCC -

21

PN ATTACHMENT 3 DRAFT FCC FORM 499-Q / PAGE 1


FCC Form 499-Q Telecommunications Reporting Worksheet

Approval by OMB

Quarterly Filing for Universal Service Contributors

> Please read instructions before completing < 3060-0855

Block 1: Contributor Identification Information

101 Filer 499 ID

102 Legal name of reporting entity

103 Filer’s IRS employer identification number

104 Name telecommunications provider is doing business as

105 Holding company
Check if filer has no affiliates:
[All affiliated companies should show same name here.]
105.1
Holding company IRS employer identification number
[Enter 9 digit number]
106 Filer’s FCC Registration Number (FRN)
[Enter 10 digit number]
107 Complete mailing address of reporting entity's corporate headquarters

Block 2: Contact Information
108

Person who completed this worksheet
First MI Last
109 Telephone number of this person
( ) -
110 Fax number of this person
( ) -
111 Email of this person

112 Billing address and billing contact person:

[Bills for Universal Service contributions
will be sent to this address.]

Block 3: Contributor Historical and Projected Revenue Information
113

Indicate which

Filing due

Historical revenues (lines 115-118) for

Projected revenues (lines 119-120) for

quarterly filing
this represents
November 1, 2012
July 1 – September 30, 2012
January 1 – March 31, 2013

February 1, 2013
October 1 – December 31, 2012
April 1 – June 30, 2013
May 1, 2013
January 1 – March 31, 2013
July 1 – September 30, 2013
August 1, 2013
April 1 – June 30, 2013
October 1 – December 31, 2013
114
Check if using safe harbor to allocate interstate/intrastate revenues for each of the following (as applicable):
Cellular & broadband PCS: Paging: Analog SMR: Interconnected VoIP:
Historical billed revenues with no allowance or deductions for
Total Revenues
Interstate Revenues
International Revenues
uncollectibles. See Instructions.

(a)

(b)
(c)
115
Telecommunications provided to other universal service



contributors for resale as telecommunications or as
interconnected VoIP
116
End-user telecommunications revenues including any pass-



through charges for universal service contributions, but
excluding international-to-international revenues
117
All other goods and services

Column (b) and (c) not requested
118
Gross-billed revenues from all sources [sum of above]

for Lines 117 and 118
119
Projected gross-billed end-user interstate and international telecommunications revenues


including any pass-through charges for universal service contributions, but excluding
international-to-international revenues
120
Projected collected end-user interstate and international telecommunications revenues


including any pass-through charges for universal service contributions, but excluding
international-to-international revenues

Block 4: CERTIFICATION: to be signed by an officer of the reporting entity

121
I certify that the revenue data contained herein are privileged and confidential and that public disclosure of such information

would likely cause substantial harm to the competitive position of the company. I request nondisclosure of the revenue
information contained herein pursuant to sections 0.459, 52.17, 54.711 and 64.604 of the Commission's Rules.
I certify that I am an officer of the above-named reporting entity, that I have examined the foregoing report and to the best of my knowledge, information and
belief, all statements of fact contained in this Worksheet are true, that said Worksheet is an accurate statement of the affairs of the above-named company for
the quarter and that the projections of gross-billed and collected revenues represent a good-faith estimate based on company procedures and policies.
122
Signature

123 Printed name of officer
First MI Last
124 Position with reporting entity

125 Email of officer (Required if available)

126 Date

127 This filing is:
Original filing
Revised filing [revisions due within 45 days of original filing deadline]
Do not mail checks with this form. Send this form to:

Form 499 Data Collection Agent c/o USAC 2000 L Street, N.W. Suite 200 Washington DC 20036


For additional information regarding this worksheet contact: Telecommunications Reporting Worksheet Info: (888)641-8722 or via email: Form 499@universalserivce.org

PERSONS WILLFULLY MAKING FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. §1001

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FCC Form 499-Q / XXX 2013 [[DRAFT]]


Document Outline

  • 2013 FCC 499-Q Instructions (final)
  • 2013 FCC Form 499-Q (final)

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