FCC Form 2301(a) Annual Reporting Form

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Overview

I. Basic Information
I(a). Narrative Description of
II. ICS Rates
II(a). Narrative Description..
III. Ancillary Service Charges
IV. Variable Site Commissions
V. Fixed Site Commissions
VI.
VII. Disability Access
FCC Notice

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Sheet 1: I. Basic Information

In the Matter of Interstate Inmate Calling Services WC Docket No. 12-375 Annual Reporting Form
FCC Form 2301(a)							Estimated Time Per Response: 80 Hours
OMB Control No. 3060-1222 /Not Yet Approved by OMB
Instructions: Please read this form carefully before completing. This form is to be completed by an officer of each provider of inmate calling services (ICS). If the provider seeks confidential treatment of any information, consistent with our rules and the Protective Order in place in this proceeding, it shall identify the specific information which it claims is subject to confidential treatment.
I. Basic Information
1. Provider Name:							2. Reporting Period:
3. Officer Name, Title:
4. Officer Telephone Number:							5. Officer E-Mail Address:
6. Total Number of Correctional Facilities Served by Provider:
7. Number of Prisons Served by Provider:
8. Number of Jails Served by Provider with Average Daily Population (ADP) of 0-349:
9. Number of Jails Served by Provider with ADP of 350-999:
10. Number of Jails Served by Provider with ADP of 1000 or more:

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Sheet 2: I(a). Narrative Description of

I(a). Narrative Description of Facilities
	1. Correctional Facilities Served Less than a Full Year: In this space, provide the names of all correctional facilities that you served for less than a full year during the reporting period and the dates during which you served those facilities (e.g.: [Facility Name], From [Month]/[Date] to [Month]/[Date]). If all correctional facilities listed in the form were served by you during the entirety of the reporting period, you must enter “N/A: No correctional facility listed in this form was served for less than a full year covered by the reporting period.” here.
	2. Explanation of Alternative Method for Determining ADP: In this space, provide the names of all jails for which the ADP reported in Section I, Items (8), (9), or (10), reflects an alternative method for calculating ADP. Also describe the method used to calculate ADP for those jails. As used in this form, an alternative method for calculating ADP is any method other than the method specified in Section I, Item (8), of dividing the sum of all inmates in a facility for each day of the preceding calendar year by the number of days in the year.
	3. Partnerships with Other ICS Providers: In this space, explain each partnership you have with any other company for the provision of ICS. This explanation shall include: the partner’s name; the name of each correctional facility subject to the partnership; the name of the primary partner; and the types of the ICS calls billed by each partner. For example: “Company [X] is the primary partner. Company [X] partners with Company [Y] for the provision of ICS at Facility [AA]. Company [X] is the billing party for all prepaid and debit calls from Facility [AA]. Company [Y] is the billing party for all collect calls from Facility [AA].” The explanation also shall include the ICS-related functions provided by each partner as well as any revenue sharing arrangement among the parties. As used in this form, “partnership” means a contract or other arrangement under which two or more entities potentially bill consumers for the provision of ICS to inmates at a correctional facility. As used in this form, “primary partner” means the partner that has the contract or other arrangement with the correctional facility’s contracting authority for the provision of ICS at that facility.

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Sheet 3: II. ICS Rates

II. ICS Rates

1. Contracting Party

2. Contract Identifier

3. Name and Location of Facilities Covered by Contract

4. Facility Type

5. ADP

6. Intrastate Rate

7. Intrastate Rates Different from Listed Rate

8. Interstate Rate

9. Interstate Rates Different from Listed Rate

10. International Rate

(a). Prepaid/Debit Rate

(b). Collect Call Rate

(a). Prepaid/Debit Rate

(b). Collect Call Rate

(a). Prepaid/Debit Rate

(b). Collect Call Rate

(a). Prepaid/Debit Rate

(b). Collect Call Rate

(a). Prepaid/Debit Rate

(b). Collect Call Rate

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Sheet 4: II(a). Narrative Description..

II(a). Narrative Description of ICS Rates
	1. Intrastate Rates Different from Listed Rate: In this space, provide all rates for any minutes of an ICS call where you charged a rate different from the Intrastate Rate provided in Section II (see Section II, Columns 6(a). Debit/Prepaid Rate & 6(b). Collect Rate):
	* Debit/Prepaid Rates:
	* Collect Rates:
	2. Interstate Rates Different from Listed Rate: In this space, provide all rates for any minutes of an ICS call where you charged a rate different from the Interstate Rate provided in Section II (see Section II, Columns 8(a). Debit/Prepaid Rate & 8(b). Collect Rate):
	* Debit/Prepaid Rates:
	* Collect Rates:

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Sheet 5: III. Ancillary Service Charges

III. Ancillary Service Charges
1. Facility Name	2. Facility Type	3. ADP	4. List of Ancillary Service Charges (Types)	5. Amounts Billed for Ancillary Service Charges	6. Number of Times Each Charge Has Been Assessed

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Sheet 6: IV. Variable Site Commissions

IV. Variable Site Commissions
1. Contracting Party	2. Contract Identifier	3. Facilities Covered by Contract	4. Facility Type	5. ADP	6. Monthly Amount of Variable Site Commission Payments

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Sheet 7: V. Fixed Site Commissions

V. Fixed Site Commissions
1. Contracting Party	2. Contract Identifier	3. Fixed Site Commissions Required by Contract	4. Facilities Covered by Contract	5. Facility Type	6. ADP	7. Fixed Site Commission Payments Required by Facility

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Sheet 8: VI.

VI. RESERVED

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Sheet 9: VII. Disability Access

VII. Disability Access
1. Facility Name	2. Facility Type	3. ADP	4. Number of Disability-Related Calls	5. Number of Problems Experienced with Disability-Related Calls	6. List of Ancillary Service Charges (Types)	7. Amounts Billed for Ancillary Service Charges	8. Number of Times Each Charge Has Been Assessed

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Sheet 10: FCC Notice

FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT

We have estimated that each response to this collection of information will take 80 hours. Our estimate includes the time to read the instructions, look through existing records, gather and maintain the required data, and actually complete and review the form or response. If you have any comments on this estimate, or on how we can improve the collection and reduce the burden it causes you, please write the Federal Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-1222), Washington, DC 20554. We will also accept your comments via the Internet if your send them to pra@fcc.gov. Please DO NOT SEND COMPLETED APPLICATIONS TO THIS ADDRESS. Remember - you are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060-1222.

THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13, OCTOBER 1, 1995, 44 U.S.C. 3507