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 PUBLIC  NOTICE  Federal  Communications  Commission  445  12th  St.,  S.  W.  Washington,  D.  C.  20554  News  Media  Information  202  /  418-  0500  Fax-  On-  Demand  202  /  418-  2830  TTY  202  /  418-  2555  Internet:  http://  www.  fcc.  gov  ftp.  fcc.  gov 
 DA  04-  3016 
 WIRELINE  COMPETITION  BUREAU  ANNOUNCES  EFFECTIVE  DATE  OF  REVISED  FORM  497  USED  TO  FILE  LOW  INCOME  CLAIMS  WITH  USAC 
 WC  Docket  No.  03-  109 
 Release  Date:  September  21,  2004 


 Beginning  October  15,  2004,  eligible  telecommunications  carriers  seeking  reimbursement  for  federal  low  income  universal  service  support  must  use  the  revised  Form  497.  This  form  may  be  found  at 
 the  Universal  Service  Administrative  Company’s  web  site:  http://  www.  universalservice.  org/  li/  whatsnew/  2004.  asp#  091704. 


 More  specifically,  carriers  that  file  Form  497s  on  a  monthly  basis  shall  use  the  revised  Form  497  for  their  October  15  filing,  which  will  contain  their  September  2004  data.  Carriers  that  file  Form  497s  on 
 a  quarterly  basis  shall  file  three  forms  on  October  15:  September  2004  data  shall  be  filed  using  the  revised  Form  497;  July  and  August  2004  data  shall  be  filed  using  the  old  Form  497.  A  copy  of  the  old 
 form  may  also  be  found  at  the  link  provided  above. 
 For  further  information,  contact  Sheryl  Todd,  Telecommunications  Access  Policy  Division,  Wireline  Competition  Bureau  at  (202)  418-  7400,  TTY  (202)  418-  0484. 
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