FCC Form 509 CONNECT AMERICA FUND-BROADBAND LOOP SUPPORT ACTUAL COST

OMB 3060-0233

[Month] 2025

Estimated time per response: 4 hours

Not yet approved by OMB

FCC Form 509, Connect America Fund-Broadband Loop Support Actual Cost and Revenue Data Collection

Information to be Submitted to Online Portal

(Note: This is a representative description of the information to be collected via the online portal and is not intended to be a visual representation of what each applicant will see).

Item Number	Field Description
1	Carrier Study Area Code
2	Carrier Study Area name
3	Data period (specify years)
4	Annual common line costs for the reporting period
5	Annual consumer broadband-only loop costs for the reporting period
6	Annual SLC revenues for the reporting period
7	Average monthly broadband-only loops
8	Average monthly broadband-only loops *12* $42
9	Lesser of annual consumer broadband-only loop costs or average monthly broadband-only loops *12* $42
10	Blended average of consumer broadband-only rates charged during time period pursuant to Section 69.132
11	Apply 11 and 8
12	Annual consumer broadband-only revenues for the reporting period (provide the greater of 12 or 10)
13	Annual special access surcharges for the reporting period
14	Annual line port costs in excess of basic analog service for the reporting period
15	Contact name
16	Contact telephone number (including area code)
17	Contact email address

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