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Form 472
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Form 472 - Billed Entity Applicant Reimbursement ("BEAR")

Introduction

FCC Form 472, Billed Entity Applicant Reimbursement ("BEAR") Form, is a special form used by applicants to request reimbursement payments or credits for approved services for which the applicant has already paid the full pre-discount amount. A separate BEAR form must be filed for every one of the applicant's vendors for which reimbursements are due.

Form Instructions

Detailed instructions for completing and mailing a Form 472 can be found:

  • In printed instructions accompanying the copy of the Form 472 included in all FCD letters.
  • On the SLD web site at: Form 472 (BEAR) Filing Guidance  and additional guidance documents.
  • A suggested format for collecting billing data for BEAR form submission is provided at the end of this section.

Preparation Tips

Tip 1: Cooperation with vendors is essential in filing BEAR forms.

The BEAR form requires that the associated vendor sign an acknowledgment (in Block 4) that appropriate discounts will be provided. The vendor's signature must be obtained by the applicant before the Form 472 can be filed. The vendor's signature need not be original but can be obtained, for example, by fax.

  • Applicants should send all four pages of Form 472 for vendor review and acknowledgment
  • Many of the larger vendors have established standard procedures, typically a centralized fax line, to process the Block 4 acknowledgments. To find the contact point for a BEAR acknowledgment, call the vendor's E-rate contact listed in the SLD's BEAR/SPIN Search database .  State-specific vendor information may very often be found on the States' E-rate Web Site.
  • Although the better vendors are prepared to be quite helpful, it is the sole responsibility of the applicant to accurately calculate reimbursement claims for eligible services and properly complete the BEAR forms.

The BEAR form requires that the associated vendor sign an acknowledgment (in Block 4) that appropriate discounts will be provided. The vendor's signature must be obtained by the applicant before the Form 472 can be filed. The vendor's signature need not be original but can be obtained, for example, by fax.

Tip 2: The deadline for submitting a BEAR is 120 days after the last date for receiving services.

  • For recurring services received by June 30, the deadline is October 28.
  • For non-recurring services, that must have been received by September 30, the deadline is January 28 of the following year.
  • The SLD reference section includes instructions for requesting an Invoice Deadline Extension.

Tip 3: Monthly charges at each end of the reimbursement period do not have to be prorated.

  • Unlike the instructions for Form 471, that required annual cost estimates to be calculated in half month increments, the SLD permits "non-calendarization" for BEAR reimbursements of monthly charges.
  • If the reimbursement period is the full fiscal year, applicants can use the entire amount (less any ineligible portions) of monthly bills for any billing dates on or after July 1, and up until and including June 30 of the following year.
  • Use of full billing periods avoids the need to prorate any portion of a monthly bill including services rendered before the start date or after the termination date. The SLD recognizes that any excess charges captured in using the first full month's bill will be approximately offset by ignoring the partial month charges included in the next bill after the termination date.

Tip 4: Follow formatting instructions carefully.

The format instruction "14.2 digits max." in Items (14) and (15) means that the dollar amounts shown should not be over 14 digits including two digits for cents.

Tip 5: Undiscounted and discounted figures, entered in Items (14)  and (15), are unlikely to equal the estimated pre-discount costs and funding commitment decisions shown in the associated FCD letter.

  • The SLD has noted that some applicants are simply, but erroneously, transferring pre-discount and approved discount amounts from their FCD letter to their Form 472, essentially claiming a reimbursement for the full and exact amount of the commitment decision.
  • Reimbursement claims made in a Form 472 must be based on the actual payments made for services, supported by bills or invoices, not simply on an estimate provided in the earlier filed Form 471. In some cases, actual and estimated amounts may match, but this is not always the case.

Tip 6: Applicants can chose check or credit for reimbursements.

Reimbursements for retroactive discounts can be received as a one-time payment or as a credit against future services. While most vendors have a preference of check or credit, the SLD has indicated that the ultimate choice should be made by the individual applicants. There is no field on the Form 472 to indicate the applicant's choice so an applicant with a strong preference should contact its vendor directly.

Tip 7: A computerized version of Form 472 is available on the web.

  • A copy of Form 472 can be downloaded and printed from the SLD web site, but cannot be first filled in online.
  • An online PDF formatted version is available on our Forms Rack. Using the free Acrobat Reader, the form can be opened, data can be filled in, and the completed form can be printed. To be able to save data entered in the PDF version of Form 472, which would be useful for applicants expecting to file multiple forms, its is necessary to purchase Acrobat Acrobat.

Tip 8: Bill Collection for BEAR Form Submission

  • Only include bills for services received and paid in full during the effective discount period. The starting date should be no earlier than the Effective Date of Discount shown on Funding Commitment Decisions ("FCD") Letter. The end date for reimbursements should be no later than the end of the funding year or any earlier Contract Expiration Date shown on the FCD letter.
  • If the bills include charges for both eligible and ineligible services, the two amounts must be separated and only the eligible portion can be claimed in the BEAR form. Separation, if required, should be on the same basis as was done when preparing the original Form 471. For local telephone service, exclude any charges for pay phones, extra directory listings, and long distance charges from other carriers.

An example of a spreadsheet that can be used to capture billing data for the effective discount period is shown below. The example is for telephone service provided under three billed telephone numbers ("BTNs"). A single account, long distance billing summary would be a much shorter attachment:

Sample Bill Summary Form

School District:____________________ SPIN #_________________________
Service Provider:___________________ Reimbursement Form #_____________
  Check Number Check Date Account Number: Billing Date Total Amount Ineligible Total Eligible
Effective Date of Discount: 3/15/05
Mar-05 11048 4/12/05 212 X00-6260 3/20/05 8,354.67 215.87 8,138.80
Mar-05 11234 4/17/05 516 790-3950 3/25/05 78.23   78.23
Apr-05 11687 4/28/05 516 M56-8575 4/5/05 3,500.00   3,500.00
Apr-05 11017 5/13/05 212 X00-6260 4/20/05 9,357.43 245.57 9,111.86
Apr-05 12245 5/18/05 516 790-3950 4/25/05 47.83   47.83
May-05 12465 5/28/05 516 M56-8575 5/5/05 3,500.00   3,500.00
May-05 12784 6/12/05 212 X00-6260 5/20/05 9,235.46 213.82 9,011.64
May-05 13012 6/17/05 516 790-3950 5/25/05 65.31   5.31
Jun-05 13468 6/28/05 516 M56-8575 6/5/05 3,500.00   3,500.00
Jun-05 13897 7/13/05 212 X00-6260 6/20/05 8,546.45 154.50 8,391.95
Jun-05 14126 7/18/05 516 790-3950 6/25/05 38.88   38.88
Jul-05 14446 7/28/05 516 M56-8575 7/5/05 3,500.00   3,500.00
Jul-05 14879 8/12/05 212 X00-6260 7/20/05 8,765.23 40.56 8,560.67
Jul-05 15214 8/17/05 516 790-3950 7/25/05 68.79   68.79
Aug-05 15657 8/28/05 516 M56-8575 8/5/05 3,500.00   3,500.00
Aug-05 15879 9/12/05 212 X00-6260 8/20/05 8,544.22 17.58 8,326.64
Aug-05 16111 9/17/05 516 790-3950 8/25/05 69.55   69.55
Sep-05 16357 9/28/05 516 M56-8575 9/5/05 3,500.00   3,500.00
Sep-05 16758 10/13/05 212 X00-6260 9/20/05 6,871.65 42.89 6,728.76
Sep-05 16019 10/18/05 516 790-3950 9/25/05 46.21   46.21
Oct-05 17136 10/28/05 516 M56-8575 10/5/05 4,000.00   4,000.00
Oct-05 17358 11/12/05 212 X00-6260 10/20/05 7,894.52 70.25 7,824.27
Oct-05 17874 11/17/05 516 790-3950 10/25/05 58.58   58.58
Nov-05 18145 11/28/05 516 M56-8575 11/5/05 4,000.00   4,000.00
Nov-05 18369 12/13/05 212 X00-6260 11/20/05 8,371.28 84.23 8,087.05
Nov-05 18769 12/18/05 516 790-3950 11/25/05 56.82   56.82
Dec-05 18968 12/28/05 516 M56-8575 12/5/05 4,000.00   4,000.00
Dec-05 19074 1/12/05 212 X00-6260 12/20/05 7,568.42 01.37 7,269.05
Dec-05 19367 1/17/05 516 790-3950 12/25/05 44.27   44.27
End of Discount Period: December 31, 2005 $ 117,083.80 $ 2,285.64 $114,702.16