CHAPTER IV: ILLINOIS STATE POLICE
PART 1329 ADMINISTRATION OF THE STATEWIDE 9-1-1 FUND
SECTION 1329.APPENDIX B FORMAT OF CARRIER REMITTANCE TRANSMITTAL
Section 1329.APPENDIX B Format of Carrier Remittance Transmittal
WIRELINE / VoIP CARRIER REMITTANCE FORM FOR ILLINOIS 9-1-1 SURCHARGE
CARRIER NAME
CARRIER FEIN 
CARRIER ADDRESS
CITY/ST/ZIP
CONTACT NAME
CONTACT PHONE #
CHECK NUMBER
CHECK DATE
REMITTANCE BREAKDOWN:
REMIT MONTH / YEAR 
Service Type Number Connections Amount Remitted
Wireline $
-
Interconnected VoIP $ -
Less 3% Admin if withheld
(Wireline and VoIP only) 3% $ -
*
* If remitting multiple months, please attach remittance detail by month on a separate page.
- The surcharge rate is $0.87 per connection, per month, for connections located outside of the City of Chicago; see section 20 of the Emergency Telephone System Act.
- Pre-paid wireless surcharge should be remitted to the Department of Revenue. Contact them, or visit http://www.tax.illinois.gov for further information.
Send Check and remittance form to:
Illinois State Police
911 Administrative Support Command
911 Surcharge
801 South 7th Street
Springfield IL 62703
POST-PAID WIRELESS CARRIER REMITTANCE FORM FOR ILLINOIS 9-1-1 SURCHARGE
CARRIER NAME
CARRIER FEIN
CARRIER ADDRESS
CITY/ST/ZIP
CONTACT NAME
CONTACT PHONE #
CHECK NUMBER
CHECK DATE
REMITTANCE BREAKDOWN:
- The surcharge rate is $0.87 per connection, per month, for connections located outside of the City of Chicago; see section 20 of the Emergency Telephone System Act.
- Post-paid wireless carriers must also email corresponding subscriber file to: 911_Admin_Support@isp.state.il.us.
Noncompliance will result in penalties.
- Per statute, wireless carriers cannot withhold 3% for admin until July 1, 2022.
- Pre-paid wireless surcharge should be remitted to the Department of Revenue. Contact them, or visit http://www.tax.illinois.gov for further information.
Send Check and remittance form to:
Illinois State Police
911 Administrative Support Command
911 Surcharge
801 South 7th Street
Springfield IL 62703