ILEC 22 Monthly Financial Report Cover Sheet by lizzy2008


									                                  NEW HAMPSHIRE PUBLIC UTILITIES COMMISSION                          NHPUC Form ILEC-22
                                   21 S. FRUIT ST., STE 10 CONCORD, NH 03301-2429                   Monthly Financial Report
                                                      603-271-2431                                               Puc 429.09
                                                                                                              Rev. 12/06/04

                                            MONTHLY FINANCIAL REPORT

Pursuant to RSA. 374:15 Filing.

                     For Month                        Calendar Year Ending

1. General Information

  Federal Identification Number         -

                         Legal Name

               Trade Name (d/b/a)
                in New Hampshire
    Contact Person (Name/Title)

                   Mailing Address

                     Phone Number           -   -
                        Fax Number          -   -

                    E-mail Address

2. Required Attachments
MR-1 Important Changes                                       MR-7 Capital Structure
MR-2 12 Months – Intrastate PUC Basis Summary                MR-8 Embedded Cost of Long-Term Debt
MR-3 Monthly Earnings Statement                              MR-9 Detail of Accounts
MR-4 YTD Earnings Statement                                  MR-10 Balance Sheet
MR-5 Earnings Statement 12 Months Ending                     MR-11 Revenue Trial Balance by Inter/Intra/Nonreg
MR-6 Summary of Investment                                   MR-12 Operating Income Statement
3. Signature and Certification

I certify that the information on this form is true and correct to the best of my knowledge and belief subject to the
penalty for making unsworn false statements under RSA 641:3.

Representative Signature                                                     Title

              Printed Name                                                   Date

      If you have any questions, please call the New Hampshire Public Utilities Commission at 603-271-2431.
      Please mail any documents to the above address.

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