20130208FCC Form 555 Virgin Mobile USA, L.P..pdf

Kristin L. Jacobson, Counsel
201 Mission Street, Suite 1500
San Francisco, CA 94105 RECEIVT Tel: [phone] Fax: [phone]
Email: kristin.l.jacobson©spnnt.com
20I3FEB-8 PM 14:53
GP Sprint> UTU ES 0-
February 6, 2013
Jean Jewell (via email: jean.jewell©puc.idaho.gov)
Commission Secretary
Idaho Public Utilities Commission
472 W. Washington
Boise, ID 83702
RE: Virgin Mobile USA, L.P.'s Annual ETC Certification
Form (FCC Form 555) in Docket No. GNR-T-13-01
Dear Ms. Jewell:
Accompanying this letter you will find Virgin Mobile USA, L.P.'s FCC Form 555 which was filed
with both the USAC and the FCC. Sprint is providing a copy of Form 555, as filed, to the Idaho
Public Utilities Commission for information purposes in Docket No. GNR-T-1 3-01. A hard copy
of this filing will be sent via U.S. Mail.
If you have any questions or concerns regarding this form, I can be reached via email at:
Kristin. l.iacobson(sDrint.com or via telephone at: 707-816-7583.
Thank you for your consideration of this matter.
Warmest Regards,
(/ Kr&t, L. Jcco&ovti
Kristin Jacobson
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'(Annually)
ID
State
(An Eligible Telecommunications Carrier (ETC) must provide a certfication form for each state in which it
provides Lifeline service).
479015 MROIN M0811.E U8A. LP- ID
Study Area Code(s) (SAC) ETC Name(s)
Sprint Nextel Corporation Assurance Wireless
Holding Company Name(s) DBA, Marketing or Other Branding Name(s)
Affiliated ETCs (include names and SACs,
attach additional sheets fnecessary)
Section 1: All ETCs (Initial the certification that applies to your ETC. Depending on the state, both
certifications may apply).
I certify that the company listed above has certification procedures in place to review income and program-based
eligibility documentation prior to enrolling a customer in the Lifeline program, and that, to the best of my
knowledge, the company was presented with documentation of each consumer's household income and/or
program-based eligibility prior to his or her enrollment in Lifeline. I am an officer of the company named above.
I am authorized to make this certification for the Study Area(s) listed above. Initial JF
479015
(List the specific SAC(s) for which you are making this certification if it is not applicable to all ofyour study
areas within the state. Attach additional sheets if necessary).
AND/OR
I certify that the company listed above confirms consumer eligibility by relying on
prior to enrolling a customer in the Lifeline program. (Please list the program eligibility data sources, such as
ETC access to a state database and/or notice of eligibility from the state Lifeline administrator and indicate for
which qualifying programs (e.g., SNAP, SSI) these sources are used to verify consumer eligibility). I am an
officer of the company named above. I am authorized to make this certification for the Study Area(s) listed
above. Initial JF
(List the specific SAC(s) for which you are making this certification (fit is not applicable to all ofyour study
areas within the state. Attach additional sheets if necessary).
11
Approved by OMB
3060-0819
FCC Form 555
November 2012
Section 2: All ETCs(Initial the certification that applies to your ETC, and ( applicable, complete columns A
through L the tables below. Attach additional sheets If necessary)
I certify that the company listed above has procedures in place to 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 state Lifeline administrator. Results are provided in the chart below. I am an officer
of the company named above. I am authorized to make this certification for the Study Area(s) listed above.
Initial JF
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
0 0
C D
-
E =C-D F G=(E+F) H
Number of Number of Number ofNon- 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 Non-
Response or ____________________ Ineligibility 0 0 0 0 0 0
I J K L
Number of Number of Customers Dc- Number of Subscribers Who Dc-Enrolled Number of Subscribers Subscribers Whose enrolled or Scheduled to be Dc- Prior to Recertification Attempt Whose Eligibility was Eligibility Was Enrolled as a Result of a Finding
Reviewed By State Examined by State of Ineligibility
Administrator or By Administrator or By
ETC Access to Eligibility ETC Access to
Data Eligibility Data and
Found to be
Ineligible
0 0 0 0
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 for
the Study Area(s) listed above. Initial JF
479015
(List the specific SAC(s) for which you are making this certification if it is not applicable to all ofyour study
areas within the state. Attach additional sheets if necessary).
Section 3: All ETCs (Initial the certification below).
I certify that the company listed above is in compliance with all federal Lifeline certification procedures I am an
officer of the company named above. I am authorized to make this certification for the Study Area(s) listed
above. Initial JF
Section 4: Non-Usage Applicable to Certain Pre-Paid ETCs (the ETC does not assess or collect a monthly fee
from its Lifeline subscribers)(Record the number of subscribers de-enrolledfor non-usage by month in column N
below).
M N
Month Subscribers De-Enrolled for Non-Usage
January 0
February 0
March 0
April 0
May 0
June 0
July 0
August 0
September 0
October 0
November 0
December 0
Signed,
Jay M. Franklin
Signature of Officer
Assistant Controller
Title of Officer
Karine hellwig
Person Completing this Certification Form
Jay M. Franklin
Printed Name of Officer
Jan-30-13
Date
913-762-5929
Contact Phone Number