TRS FUND FORM 1.docx

IDAHO TRS FUND FORM 1.2Rates as of May 1, 2021
DUE DATE: FIRST OF THE MONTH OR QUARTERLY
COMPANY NAME:  _____________________________________________________________________
REPORTING PERIOD:   __________________________ TO:  ____________________________________
Date Submitted:  ______________________________________________________________________
____________________________________________________________________________________
LOCAL EXCHANGE SERVICES: 
# of linesRevenues
TOTAL # OF LINES ______________ X $0.05
TOTAL LOCAL FUND REVENUES = ______________
______________________________________________________________________________
MTS AND WATS TYPE TOLL SERVICES: 
INTRASTATE BILLED MTS AND WATS MINUTES X______________ X
SURCHARGE RATE $0.001$0.001
B TOTAL MTS/WATS FUND REVENUES = ______________
______________________________________________________________________________TOTAL DUE: 
TOTAL AMOUNT DUE= ______________
ADD LINES A AND B
_____________________________________________________________________________________
PREPARED BY: ______________________   _______________   _________________________________NamePhoneEmail
APPROVED BY: ______________________   _______________   _________________________________NamePhoneEmail
_____________________________________________________________________________________
Questions? E-mail Kelli Toohill at [e-mail] or call at 406-697-0447/604-652-0447
PLEASE MAKE CHECKS PAYABLE TO:
Idaho TRS Fund
600 Front Street #351
Lynden, WA 98264Rev. 05/21