Monthly LEC Supplemental Assistance Charge and Contribution Report

LEC

Month

Contributions:

a)

Total Contribution Billed

b)

Less Uncollectible Contributions

from previous months

c)

Total Contributions

Supplemental Assistance:

a)

Total Supplemental Installation Charges

(Exhibit A, line 2.2)

b)

Total Monthly Supplemental

Assistance (Exhibit A, line 4.3)

c)

Total Supplemental Assistance

Amount Due from UTSAP Administrator

(Supplemental Assistance exceeds Contributions)

or

Amount to be Remitted to UTSAP

Administrative (Contributions exceed

Supplemental Assistance

Administrative Costs

Total UTSAP Expenditures

(Exhibit A, 2 of 2 "Totals")

Note:  Exhibit B is to be forwarded monthly to the UTSAP Administrator by LECs with more than 35,000 access lines and quarterly by LECs with fewer than 35,000 access lines.