Forms

Annual ECD Certification

• Annual ECD Certification Form

Carrier Monthly Remittance

• Remittance Calculator
• Carrier Monthly Remittance Report - Printable (Lotus)
• Carrier Monthly Remittance Report - Printable - (Excel)

Form for carriers to submit monthly 9-1-1 service charges Information regarding ACH transfers or direct deposit to the Board’s account is on this form.

Direct Deposit Agreement

• ECD Direct Deposit Form



• Carrier Direct Deposit Form

If you would like to have your distribution or your cost reimbursement check deposited directly into your account, please complete this form and return to F. Ralph Dowdy by mail (not email or fax) at the following address:

F. Ralph Dowdy
MDA Professional Group, P.C.
307 Clinton Avenue, West Suite 500
Huntsville, AL 35801

The bank will perform a “test run” before any funds are transferred.

Cost Recovery Plans for Carriers FYE 9/30/12

• Cost Recovery Plan Cover Letter
  and Instructions for FYE 9/30/12

• Blank Survey Form

• Reimbursement Request Form for
  Phase I Implementation Costs

Annual Cost Recovery Statement
FYE 9/30/11

• Annual Cost Recovery Statement Instructions

• Annual Cost Recovery Statement Cover Letter

• Phase I Annual Cost Recovery Statement Form

• Phase II Annual Cost Recovery Statement Form

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