TITLE 83: PUBLIC UTILITIES
CHAPTER I: ILLINOIS COMMERCE COMMISSION
SUBCHAPTER f: TELEPHONE UTILITIES
PART 729 ADMINISTRATION OF FUNDS CREATED BY THE WIRELESS EMERGENCY TELEPHONE SAFETY ACT
SECTION 729.APPENDIX B FORMAT OF CARRIER REMITTANCE TRANSMITTAL


 

Section 729.APPENDIX B   Format of Carrier Remittance Transmittal

 

CARRIER REMITTANCE OF WIRELESS E9-1-1 FUNDS

 

CARRIER NAME

 

 

 

 

 

 

CARRIER FEIN

 

 

 

 

 

 

 

 

 

 

 

 

 

CARRIER ADDRESS

 

 

 

 

 

 

CITY/ST/ZIP

 

 

 

 

 

 

CONTACT NAME

 

 

 

 

 

 

CONTACT PHONE #

 

 

 

 

 

 

 

 

 

 

 

 

 

REMITTANCE AMT

 

 

 

 

 

 

 

 

 

 

 

 

CHECK NUMBER

 

 

 

 

 

 

CHECK DATE

 

 

 

 

 

 

 

 

REMITTANCE MONTHLY BREAKDOWN:

 

 

MO/YR Billed

 

Amount Remitted

 

 

 

/

 

 

 

 

 

 

/

 

 

 

 

 

 

/

 

 

 

 

 

 

/

 

 

 

 

 

 

/

 

 

 

 

 

 

/

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

TOTAL REMITTED

 

 

 

 

$

**

 

 

 

 

 

 

 

 

** Must agree with Remittance Amount listed at top of form.

 

Send Check and remittance to:

 

Illinois Commerce Commission

IL WETSA

527 East Capitol Avenue

Springfield, IL  62701