20130201FCC Form 555 Inland Cellular.pdf

INLAND CELLULAR TELEPHONE COMPANY
Corporate Offices
103 S. 2nd St.
P.O. Box 688
Roslyn, WA 98941
Telephone: 509, 649-2500
Fax: [phone]
January 31, 2013
j,-r-13-0 I
Idaho Public Utilities Commission
Commission Secretary
472 W. Washington
P.O. Box 83720
Boise, ID 83720-0074
Re: Pursuant to IPUC Order No. GNR-T-13-01
2013 Federal Lifeline Certification and Reporting
Pursuant to 47 C.F.R. § 54.416(b)
Dear Commission Secretary:
Pursuant to 47 C.F.R. § 54.416(b), accompanying this letter for
filing with the Idaho Public Utilities Commission ("Commission") is a copy
of the completed FCC Form 555 ("Annual Lifeline Eligible
Telecommunications Carrier Certification Form"), for the reporting year
ended December 31, 2012, that has been submitted by Inland Cellular
Telephone Company, Washington RSA No. 8 Limited Partnership (d/b/a
Inland Cellular) ("Company") (SAC 479007) to the Universal Service
Administrative Company (USAC) with respect to the Company's Lifeline
service subscribers residing in the State of Idaho.
Please let us know if the Commission has any questions regarding
the information presented on the accompanying form.
James K. Brooks
Treasurer/ Controller
Accompanying document
Approved by OMB
3060-0819
FCC Form 555
November 2012
Annual Lifeline Eligible Telecommunications Carrier Certification Form
All carriers must complete Sections 1, 2, and 3 Carriers must complete Section 4, if applicable
Deadline: January 31'(AnnuaIly)
Idaho
State
(An Eligible Telecommunications Carrier (ETC) must provide a cert /Ication form for each state in which it
provides Lifeline service).
479007 Washington RSA No 8 Limited Partnership
Study Area Code(s) (SAC) ETC Name(s)
Inland Cellular Telephone Company Inland Cellular
Holding Company Name(s) DBA, Marketing or Other Branding Name(s)
Affiliated ETCs (include nanes and SACs,
attach additional sheets f necessary) Additional Sheet Attached
Section 1: All ETC's (Initial the certj/ication that applies to your ETC. Depending on the state, both
certifications may apply).
documentation of each con
nrollment in Lifeline. I am named above.
AND/OR
CAPA of daho
in the
the state
I am an
Notice of ellgibIty is received via email from the Community Action Partnership Association (cAPA) of Idaho
Section 2: All ETcs(fnitial the certification that applies to your ETC, and if applicable, complete columns A
through L the tables below. Attach additional sheets ifneccssaiy).
I certify that the company listed above has procedures in place 10 re-certify the continued eligibility of all of its
Lifeline customers, and that to the best of my knowledge, the company obtained signed certifications from all
consumers attesting to their continuing eligibility for Lifeline, except those subscribers whose eligibility was
verified by the company through the use of other sources of eligibility information as well as those subscribers
who were re-certified by the slate Lifeline administrator. Results are provided in the chart below. I am an officer
of the coany named above. I am authorized to make this certificatioii for the Study Area(s) listed above.
Iiiitia! ((1
A B
Number of Number of
Subscribers lines
Claimed on Claimed on
May FCC May FCC
Form(s) 497 Form(s) 497
Provided to
Wireline
Resellers
93 0
C D E =C-D F G = (E'F) I-I
Number of Number of Number of Non- Number of Number of Number of
Subscribers ETC Subscribers Responding Subscribers Subscribers Dc- Subscribers Who
Contacted Directly Responding to Subscribers Responding That Enrolled or Dc-Enrolled Prior
to Recertify ETC Contact They Are No Scheduled to be to Recertification
Eligibility Through Longer Eligible Dc-Enrolled as a Attempt
Attestation Result of NORM
Response or
ineligibility
Number of
Number of Subscribers Subscribers Whose
Whose Eligibility was Eligibility Was
Reviewed By State Examined by State
Administrator or By Administrator or By
ETC Access to Eligibility ETC Access to
Data Eligibility Data and
Approved by OMB
3060-0819
FCC Form 555
November 2012
OR
I certify that my company did not claim federal Low Income support for any Lifeline customers prior to June
(insert current year). I am an officer of the company named above. I am authorized to make this certification f
-
or
the Study Area(s) listed above. Initial _____
areas within the state. Attach additional sheets If necessary).
Section 3: 4IIETCs (Initial the certification below).
I certi1Y that the company listed above is in compliance with all federal Lifeline certification procedures. I am an
officer of the cW named above. I am authorized to make this certification for the Study Area(s) listed
above. Initial
e ETC does not assess or collect amanthlyfee
de-enrolledfor non-usage by month in column N
i•tpptOVU uy iJivi
3060-0819
FCC Form 555
'November 201,2
U
I
ETC Identification
SAC ETC Name
472423 Inland Telephone Company
$22423 Inland Telephone Company
479007 Washington RSA No. 8 Limited Partnership
529003 Washington RSA No. 8 Limited Partnership
529004 gastern Sub-RSA Limited Partnership