Fees 75+6+7 INFO

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					          WIRE LINE TELEPHONE SERVICE PROVIDER COMPANY NAME                                                                 DATE

                                           9-1-1 = 75¢ / TAM = 6¢ / TAP = 7¢                     TOTAL = 88¢

                                                    FEE AMOUNTS BEGINNING JULY 1, 2009
TO: ECN 9-1-1 Program                                                   Company Contact:
        445 Minnesota Street, Town Square, Suite 137                    Name:
        St. Paul, Minnesota 55101-5137                                  Phone:
        Fax: 651 296-2665                                                 Fax:
        Email: carol.schmidt@state.mn.us                                Email:
                  Fees are due to the Minnesota 9-1-1 Program by the 25th of the month following the month of collection.
                           The 9-1-1 emergency telephone service fee, TAM (Telecommunications Access Minnesota), and
                                  TAP (Telephone Assistance Program) fees are remitted for the following period:
                                (Fees totaling less than $25.00 per month will be submitted annually using a different form.)


             Month/Year                                              ($250.00 or more).
                     OR
             Quarter/Year                                            (less than $250.00/month but more than $25.00/month).

1.      Total monthly local access customer lines (include customers listed as fee adjustment in line 3)
             Enter the number of customers in both lines if applicable.
        Monthly       Quarterly
                                Total local access customers lines
                                Access lines based on trunk equivalency (ratio ___:___)                   {
                                                                                                      total both lines          }                      0


2.      Unadjusted fee amount (all access lines reported under item 1 x 88¢)                                                         $              0.00

3.      Adjustments for fees pro rated on a daily basis for partial monthly service.
                 Fees prorated on a daily basis for partial monthly service                                                 - or +   $
                 Seasonal disconnects or reconnects                                                                         - or +   $
                 Bad debts subtraction for this month *                                                                          -   $
                 Recovered bad debts for previous month *                                                                        +   $
                 Federal customers who requested exemption of the fees *                                                         -   $
                 Other adjustments - describe on separate page or reverse side of this form                                 - or +   $
                 * Attach list of customer name, address, and phone number.

4.      Amount of remittance (line 2) plus or minus adjustments (amounts under line 3).                                              $              0.00


      I certify that I am a manager or officer of this telecommunications company and that this report is accurate and true and reflects the
                         appropriate customer access line count including trunk equivalents, adjustments, and fee amount.
     Certified by:                                                                                         Date signed:
                              (signature of telecommunications company manager or officer)
 Printed name:
      Phone #:                                              Email:

                                    MAKE CHECKS PAYABLE TO:                      MINNESOTA 9-1-1 PROGRAM
                             (If you have any questions regarding this collection, please contact Carol Schmidt at 651-201-7549)

          --------------   DO NOT WRITE BELOW THIS LINE - STATE OF MINNESOTA OFFICE USE ONLY                                         ------------


Check #
Amount $                                                                 E9-1-1 $
Date rec'd                                                                TAM $
Deposit #                                                                  TAP $

FEES 75+6+7
                                9-1-1 / TAP / TAM MONTHLY SERVICE FEE FOR
                                        WIRE LINE TELEPHONE SERVICE
                               TAP = Telephone Assistance Plan / TAM = Telecommunications Access Minnesota

    What are the 911, TAP and TAM service fees? They are an assessment against each wireless or other non-wire access services, local
    service access line, prepaid, centrex trunk equivalent, or packet-based telecommunications services to administer the Department of
    Public Safety Statewide 911 Program, the Department of Commerce Telecommunications Access Minnesota Program, and the Public
    Utilities Commission Telecommunications Assistance Program. EFFECTIVE JULY 1, 2009, the 911 fee amount increases to 75¢, TAM
    remains at 6¢, and TAP remains at 7¢. This fee submission form is available on the 911 website under Service Provider Info at
    http://www.911.state.mn.us/911_Fee_InfoandForms.asp

                                               * IMPORTANT CHANGES AND Q & A
*   Effective until June 30, 2009, the 911 fee is 65¢, the TAM fee is 7¢, and the TAP fee is 6¢ for a combined fee total of 78¢.


*   Effective July 1, 2009 the 911 fee increases to 75¢ and the combined 911 / TAM / TAP fee total will be 88¢.


    When should collected fees be submitted? Submit fees with this form to the address indicated on the form by the 25th of each month
    following the month of collection. Example: June monthly collection or quarterly collections for April, May and June are due by July
    25th. If fee collections are not received at the Department of Public Safety, Statewide 911 Program within 20 days after the due date,
    companies will be reported to the State Department of Revenue's Minnesota Collection Enterprise. Debt collection fees of 15 to 20%
    will be added to the total amount due in accordance with Minnesota Statutes, Chapter 16D.

    Do the fees apply to federal customers? If federal government customers refuse to pay the fees, companies can consider them exempt.
    This is a constitutional matter involving a state's power to collect from the federal agencies.

    Do the fees apply to other tax-exempt organizations? Yes. The fees are not taxes. Except for the cost of 911 program management,
    911 receipts are allocated to pay for 911 call delivery, features, and other 911 related expenses. Likewise, the TAM and TAP fees pay
    only for the cost of administering and implementing the TAM and TAP programs.

    Do the fees apply to one-way trunks, such as used in a direct-inward-dial PBX system? Yes. Although an incoming PBX trunk
    would not be used to dial out, it is part of a local premises system that can access the switched network.

    Do the fees apply to 911 outswitching charges? No. Nine-one-one trunks are not local service access lines in that they do not access
    the switched network.

    Should the fees be applied to seasonal disconnect telephones? No. During periods of disconnection, the fees do not apply to local
    service access lines temporarily disconnected for seasonal service reasons.

    What are the telephone company's options in collecting the fees? At your option, the entire fee may apply for any period of service
    covering more than one-half of the applicable month, or it may be pro-rated on a daily basis. If you choose to pro-rate the fee, amounts
    less than $.05 per customer need not be collected.

    How should the fees appear on customer bills? Minnesota Statutes, Chapter 237, Section 49 states: “A company or the billing agent
    for a company shall list the surcharges as one amount on a billing statement sent to a subscriber.” The Public Utilities Commission
    recommends that the surcharges be listed as "9-1-1, Tele-Relay, and TAP surcharges" on customer bills.

    Should the fees be billed until paid? Yes. For example, if a subscriber refuses to pay the TAP fee for one month, the 7¢ balance should
    be carried forward and added to the normal fee amount on a subsequent bill.

    Is a telephone company responsible for submitting fees that are not collected? No. If a customer refuses to pay the fee, however,
    report refusal to pay the fee to the Department of Public Safety on the form that accompanies the payment. The Public Utilities
    Commission also requires the reporting of TAP fee refusals as part of the quarterly/monthly TAP reports.

                     9-1-1 questions should be referred to Jackie Mines, MN Department of Public Safety at 651-201-7550.
                      TAP questions should be referred to Roger Moy, MN Public Utilities Commission, at 651-201-2217.
                    TAM questions should be referred to Rochelle Garrow, MN Department of Commerce, at 651-297-8941.

    FEES 75+6+7