trsform.pdf

IDAHO TRS FUND FORM 1 . 1

DUE DATE: FIRST OF THE MONTH OR QUARTERLY

COMPANY NAME

REPORTING
PERIOD:
TO

LOCAL EXCHANGE SERVICES:
# of lines revenues

TOTAL # OF LINES X $0.02

A. TOTAL LOCAL FUND REVENUES=

MTS AND WATS TYPE TOLL SERVICES:

INTRASTATE BILLED MTS AND WATS MINUTES

SURCHARGE RATE $0.0002

B TOTLAL MTS/WATS FUND REVENUES=

TOTAL DUE:

C. TOTAL AMOUNT DUE=
ADD LINES A AND B

PREPARED BY: PHONE:
Date

APPROVED BY: PHONE:
Date

Questions? Call BOB DUNBAR AT

PLEASE MAKE CHECKS PAYABLE TO
IDAHO TRS FUND

PHONE [phone]
email: [e-mail]
2545 NORTH WAGGLE PLACE
MERIDIAN ID 83646

I:/internet/telecom/trsform.doc Rev. 4/09