Simul­ta­ne­ous­ly, with the remit­tance of the sur­charge amount to the­Coun­tyTrea­sur­er, each telecom­mu­ni­ca­tion car­ri­er shall make a return to the­Coun­tyTrea­sur­er and to any Emer­gency Tele­phone Sys­tem Board which may be cre­at­ed in the future, stat­ing the fol­low­ing for the peri­od for which the remit­tance applies:

(A) The name of the telecom­mu­ni­ca­tions carrier.

(B) The telecom­mu­ni­ca­tion carrier’s prin­ci­pal place of business.

(C) The num­ber of net­work con­nec­tions to which a sur­charge applies.

(D) The amount of sur­charge due.

(E) Any amounts which may have been deduct­ed by the telecom­mu­ni­ca­tion car­ri­er pur­suant to this Arti­cle or pur­suant to State statute.

(F) Such oth­er infor­ma­tion as the Coun­ty of Union or an Emer­gency Tele­phone Sys­tem Board, which may here­after be cre­at­ed, may require.