Credit Balance Refund Request Form - Universal Service ... - usac 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Company Name and Filer ID in the designated fields. Ensure that these details match your official records.
3. Input your Bank Routing Number (9 digits) and Bank Account Number. Double-check these numbers for accuracy, as they are crucial for processing your refund.
4. Fill in the Company Officer's Name, Title, and Phone Number. This information is essential for verification purposes.
5. Sign the form in the designated area and include the Signature Date. If the signing officer is not listed on your FCC Form 499-A, ensure that this form is notarized.
6. Attach any required documentation, such as a voided check or bank statement, to verify your banking information before submitting.
7. Once completed, download the form and mail it to USAC at the provided address by the 25th of the month to ensure timely processing.

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