ALL FORMS MUST BE FILED ONLINE IN ROLKA LOUBE’S PORTAL. PAYMENT INFORMATION REMAINS THE SAME. ONLINE PAYMENT OPTION NOW AVAILABLE!
If you have not yet created an e-filing account, do so by registering with Commission's e-filing system.
If your company is not yet registered with the Commission, do so by completing the Combined Telecommunications Surcharge Registration Form and filing it in the appropriate proceeding number listed on the form using the Commission's e-filing system. Once filed, you will receive a company code from Rolka Loube, the custodial receiver.
Download the Surcharge Remittance Form. The form is in Excel format. You will need to download it to your local desktop to fill it out. Once you've downloaded it, you can save a blank copy to use in future months.
Amended or New? Click on the space next to this question, choose "Amended" or "New" from the dropdown box. If this is the first time you have submitted a form for this month, select "New". If you're submitting this form to replace one previously submitted, select "Amended".
Line 1: Enter the date that the form will be filed with the Commission.
Line 2: Enter the month in which the customer was charged. Surcharges remittances are due by the last day of the month following the month in which they were collected. Example: Surcharges collected from customers in January are due to be remitted by the last day of February, you and would enter January in line 2.
Line 3: This field cannot be changed. This form is for use for Calendar Year 2023 only. If remitting for another year, choose the correct form from the list on the PUC Surcharges Page.
Line 4: Enter the number of months late. Example: Surcharges collected in January must be remitted by the last day of February. If surcharges are being remitted in February, enter "0". If surcharges collected in January are being remitted in March, enter "1". If surcharges collected in January are being remitted in April, enter "2", etc.
Line 5: Enter your company name. This should be the name that you are registered in e-filings.
Line 6: Enter your Company Code. You should have received this code after registering your company using the Combined Telecommunications Surcharge Registration Form.
Line 7: Total TDM/Landlines. Enter the total number of landlines provided to end users by your company in Colorado. For this and the next two lines, customers are considered to be Colorado customers based on the service address, if known, or the billing address, if service address is unknown.
Line 8: Total Wireless Lines. Enter the total number of wireless lines provided to end users by your company in Colorado. This includes Satellite phone users. This does not include prepaid wireless telecommunications customers. For prepaid wireless telecommunications surcharges, please see the Colorado Department of Revenue.
Line 9: Total Voice-over-Internet Protocol Lines. Enter the total number of VoIP lines provided to end users by your company in Colorado. For multi-line telephone systems, the total number of lines equals the total number of simultaneous outbound calls the system is configured to be capable of making.
Line 10: Total Lines. This field is automatically calculated.
Line 11: Total Federal Lifeline Customers. Enter the total number of customers, regardless of line type, for which the company is receiving federal Lifeline subsidies.
Line 12: Uncollected. Enter the total number of lines for which the company was unable to recover surcharges. Failure to bill customers for surcharges does not alleviate the responsibility to remit said surcharges, but customers who were billed the surcharge and didn't pay it should be counted here.
Line 13: Total Lines for 9-1-1 and 9-8-8. This line is automatically calculated.
Line 14: Total Lines for TRS. This line is automatically calculated.
Line 15: 9-1-1 Surcharge Rate for 2023. This line cannot be changed.
Line 16: 9-8-8 Surcharge Rate for 2023. This line cannot be changed.
Line 17: TRS Surcharge Rate for 2023. This line cannot be changed.
Line 18: Base 9-1-1 Surcharge Liability. This line is automatically calculated.
Line 19: 9-1-1 Vendor Fee. This line is automatically calculated. If the 9-1-1 surcharges are remitted by the due date, the vendor is entitled to retain 1% of the surcharges. This line calculates the amount that the vendor is allowed to retain.
Line 20. 9-1-1 Late Fee: This line is automatically calculated. 9-1-1 fees remitted after the due date are assessed a 15% late fee, plus an additional 1% of the base amount per month.
Line 21: Base 9-8-8 Liability. This line is automatically calculated.
Line 22: 9-8-8 Vendor Fee. This line is automatically calculated. If the 9-8-8 surcharges are remitted by the due date, the vendor is entitled to retain 1% of the surcharges. This line calculates the amount that the vendor is allowed to retain.
Line 23: 9-8-8 Late Fee. This line is automatically calculated. 9-8-8 fees remitted after the due date are assessed a 15% late fee, plus an additional 1% of the base amount per month.
Line 24: Base TRS Liability. This line is automatically calculated.
Line 25: TRS Vendor Fee. This line is automatically calculated.
Line 26. 9-1-1 Surcharge Remittance Due. This line is automatically calculated. This is the amount of 9-1-1 surcharge owed by the company.
Line 27. 9-8-8 Surcharge Remittance Due. This line is automatically calculated. This is the amount of 9-8-8 surcharge owed by the company.
Line 28. TRS Surcharge Remittance Due. This line is automatically calculated. This is the amount of TRS surcharge owed by the company.
Line 29. Total 9-1-1, 9-8-8, and TRS Surcharge liability. This line is automatically calculated.
Complete the "Prepared By" and "Approved by" sections. An image of the signature may be placed in the "Signature" cell, if desired, or the name of the person signing can be typed into the field.
File the completed form using your e-filing account in Proceeding Number 23M-TELCOSURCHARGE .
If paying by check by USPS, pay the total amount from Line 29 to:
State of Colorado
P.O. Box 69540
Baltimore, Maryland 21264-9540
Include a copy of the completed form with your payment.
If paying by ACH, payments must be made separately to the following accounts:
Routing number for all accounts: 21052053
TRS Account Number: 35293302
911 Account Number: 12845745
988 Account Number: 55791846
If paying by check and overnight express mail, pay the total amount from Line 29 to:
MT Bank c/o State of Colorado
P.O. Box 69540 Box #69540
1800 Washington Blvd. 8th Floor
Baltimore, Maryland 21230
Include a copy of the completed form with your payment.