HomeMy WebLinkAbout20140203CenturyLink QC-Qwest Form 555.pdfM"ry S. Hobson
Attorney & Counselor
ggg Main, Suite rros
Boise, lD 8g7oz
908-C85-8666
January 31,2014
Jean D. Jewell, Secretary
Idaho Public Utilities Commission
472West Washington
Boise,lD 83702-5983 cNR-T-t4-D I
Re: Qwest Corporatio n (dlb I a "Centurylink QC") Lifeline Certifi cation
Dear Ms. Jewell:
Pursuant to the Federal Communications Commission's Report and Orderl requiring
eligible telecommunications carriers to re-certifu the eligibility of their Lifeline
subscribers and to report the results to the Federal Communications Commission,
Universal Service Administrative Company and to state commission and Tribal
governments, Centurylink hereby submits its 2013 Lifeline re-certification results for the
state of Idaho.
Please contact me at (208) 385-8666 if you have any questions.
Sincerely,
,Lt"d
Mary S. Hoh#n
l"ld---'1.--
Attomey for Centurylink
I In the Matter of Lifeline and Link tlp Reform and Modernization, Lifeline and Link Up,
Federal-State Joint Board on Universal Service, Advancing Broadband Availability
Through Digital Literacy Training, Report and Order and Further Notice of Proposed
Rulemaking, 27 FCC Rcd 6656, 6715-16 n 132 (2012);47 C.F.R. $ 54.416. Also see
Public Notice, 28 FCC Ptcd 12947 (2013).
Approved by OMB
3060-08 l9FCC Form 555
December 2013
Annual Lifeline Eligible Telecommunications Carrier Certification Form
All carriers must complete all or portions of all sections
Form must be submitted to USAC and filed with the Federal Communications Commission
IMPORTANT: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 3l't (Annually)
State
(An Eligible Telecommunications Carrier (ETC) must provide a certificationformfor each state inwhich it provides Lifeline semice).
See Attached Sheet -See Attached Sheet-
Study Area Code(s) (SAC)
-See Attached Sheet-
ETC Name(s)
-See Attached Sheet-
Holding Company Name(s)DBA, Marketing or Other Branding Name(s)
Affiliated ETCs (include names and SACs, attach -See Attached Sheet-ional sheets if necessary)
Provide a list of all ETCs that are ffiliatedwith the reporting ETC. Afiiliation shall be determined in accordance with section 3(2) of the
Communications Act. That Section defines "ffiliate" as "a person that (directly or indirectly) owns or controls, is owned or controlled by, or is
under common ownership or control with, another person." 47 U.S.C. S 153(2). See also 17 C.F.R. S 76.1200.
For purposes of this filing, an officer is an occupant of a position listed in the article of incorporation, articles of
formation, or other similar legal document. An officer is a person who occupies a position specified in the corporate by-
laws (or partnership agreement), and would typically be president, vice president for operations, vice president for
finance, comptroller, treasurer, or a comparable position. If the filer is a sole proprietorship, the owner must sign the
certification
Section 1: All ETCs MUST COMPLETE SECTION 1-Initial CertiJication
I certiff that the company listed above has certification procedures in place either to:
A) Review income and program-based eligibility documentation prior to enrolling a consumer 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 or
B) Confirm consumer eligibility by relying upon access to a state database and/or notice of eligibility from the
state Lifeline administrator prior to enrolling a consumer in the Lifeline program.
I am an officer of the company named above. I am authorized to make this certification for the Study Area(s)
listed above. Initial JMA
FCC Form 555
December 2013
Section 2: All ETCs MUST COMPLETE SECTION 2- Annual RecertiJication
Do not leave empty columns. If an ETC has nothing to report in a column, enter a zero.
Approved by OMB
3060-0819
A B C
Number of
Subscribers Claimed on
Februrry FCC Form(s) 497
of current Form 555
calendar yeer
Number of Lines Claimed on
February FCC Form(s) 497
ofcurrent Form 555
calendar yeer provided to
Wirelinc Resellers
Numbcr of Subscribers claimed
on the February FCC Form(s)
497 that were initially enrolled in
current Form 555 calcndar yerr
9150 0 881
Initial the certiJications below that qpply to your ETC and complete the tables corresponding to the certification below. Depending on
the state, BOTH CERTIFICATION A AND B MAy APPLY.
A) I certiff that the company listed above has procedures in place to recertify the continued eligibility of all of its Lifeline
subscribers, and that, to the best of my knowledge, the company obtained signed certifications from all subscribers
attesting to their continuing eligibility for Lifeline. 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 S
D E F:D-E G 11= (p+G)I
Number of
Subscribers ETC
Contacted Directly
to Recertifo
Eligibility Through
Attestation
Number of
Subscribers
Responding to
ETC Contact
Number ofNon-
Responding
Subscribers
Number of
Subscribers
Responding That
They Are No
Longer Eligible
Number of Subscribers
De-enrolled or
Scheduled to be De-
Enrolled as a Result of
Non-Response or
Inelisibilitv
Number of
Subscribers Who
De-Enrolled Prior
to Recertilication
Attempt
24 l0 t4 0 t4 0
AND/OR
In the space below, please list the program eligibility data sources, such as ETC access to a state database and/or notice ofeligibility
from the state Lifeline administrator or the Universal Service Administrative Company (USAC) and indicate for which qualifuing
programs (e.g., SNAP, SSI) these sources are used to verifu subscriber eligibility. If any of subscribers are subsequently contacted
directly by the ETC in qn attempt to recertifu eligibility, those subscribers should be listed in columns D through I as appropriqte and
not in columns J through L.
B) I certify that the company listed above has procedures in place to re-certiff consumer eligibility by relying on
CAPAI / ID PUC . RCSUITS ArC
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 JMA
J K I,
Number of Subscribers
Whose Eligibility was
Reviewed By State
Administrator
ETC Access to Eligibility
Data or bv IISAC
Number of
Subscribers De-Enrolled or
Scheduled to be De-Enrolled as a
Result of Finding of Ineligibility by
State Administrator, ETC Access to
Elisibilitv Data or USAC
Number of Subscribers Who
De-Enrolled Prior to
Recertification Attempt
8491 2207 0
OR
C) I certiff that my company did not claim federal low income support for any Lifeline subscribers for the February Form
497 datamonth for the current Form 555 calendar 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
-
FCC Form 555
December 2013
Section 3: ALL ETCS MUST COMPLETE SECTION 3 -De-enroll percentage
ll/hat is the percentoge of subscribers de-enrolled for this ETC?
Approved by OMB
3060-0819
M N o P=N+O Q = ((P+ M) * r00)
Number of
Subscribers Claimed
on Fcbruary FCC
Form(s) 497
(From Column A)
Number ofSubscribers
De- Enrolled or
Scheduled to be De-
Enrolled as e Result of
Non-Response or
Ineligibility
(From Column H)
Number of Subscribers
De- Enrolled or
Scheduled to be De-
Enrolled as a Result of
r Finding of Ineligibility
(From Column K)
Total Numbcr of
Subscribers Dc-Enrolled
or Scheduled to be De-E
nrolled
Percentage of Subscribers
De-Enrolled or Scheduled tr
be De-Enrolled that were
Claimed on the
Fcbrurry FCC Form(s) 497
9150 t4 2207 2221 24%
SCCIiON 4: ALL ETCS MUST COMPLETE APPROPRIATE CHECK BOX; PRE-PAID ETCS MUST COMPLETE
ALL OF SECTION 4
Is the ETC Pre-Poid?
Yes E lfa Z 6e fre-faid ETC does not ctssess or collect a monthlyfeefrom its Lifeline subscribers)
If yes, record the number of subscribers de-enrolledfor non-usage by month in column S below.
Non-Usoge Results Applicable to Pre-Paid ETCs:
R s
Month Subscribers De-Enrolled for Non-I]sase
January
Februarv
March
Anril
May
June
July
August
Seotember
October
November
December
Signature Block: ALL ETCS MUST COMPLETE SIGNATURE FIELDS
By signing below, I certiff 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.
Approved by OMB
3060-0819FCC Form 555
December 2013
Signed,
Jerry M. Allen
Signature of Officer
Vice President of Revenues
Title of Officer
Tom Nehls
Person Completing this Certification Form
Printed Name of Officer
Jarl.-28-14
Jerry M. Allen
Date
720-s78-5326
Contact Phone Number
Approved by OMB
3060-08 1 9FCC Form 555
December 2013
ETC Identification
SAC ETC Name
472225 Centurvlink CenturvTel of Idaho Inc.
475162 Centurylink Qwest Comoration
475103 CenturvLink Owest Cornoration
472223 CenturvLink CenturvTel of the Gem State (Nevada)
Holdins Company Name
or Other Bra
Approved by OMB
3060-0819FCC Form 555
December 2013
Affiliated ETCs
SAC Name
330884 CenturyLink CenturyTel of Forestville LLC
331159 Centurylink CenturvTel of Central Wisconsin LLC
3s1274 CenturvLink CenturvTel of Postville Inc.
535 163 Centurylink Qwest Corporation
331 155 Centurylink Telephone USA of Wisconsin LLC
46s102 CenturyLink Qwest Corporation
401727 Centurylink CenturyTel of South Arkansas Inc.
442101 Century Link CenturvTel of Lake Dallas Inc.
330895 Centurvlink CenturvTel of Wisconsin LLC
36s142 Centurylink Qwest Comoration
401720 Centurylink CenturyTel of Redfield Inc.
552348 CenturyLink Central Telephone Co. ofNevada (FKA)
330898 CenturvLink CenturvTel of Laresen-Readfield LLC
442084 Centurylink United Teleohone Co of Texas Inc. FKA Embarc
4017 ll CenturvTel of Mountain Home Inc.
190s67 Centurylink United Telephone-Southeast Inc. (FKA Embarq)
401705 Centurylink CenturyTel of Arkansas Inc.
230485 Centurylink MebTel Inc.
485104 CenturyLink Qwest Corporation
515108 CenturvLink Owest Corporation
320747 CenturvTel ofCentral Indiana Inc.
3309 I 3 Centurvlink CenturvTel of Monroe Countv LLC
475103 CenturyLink Qwest Corporation
330924 Centurylink CenturyTel of the Midwest-Kendall LLC
330922 )enturyLink CenturyTel of the Midwest-Wisconsin (Northwest
45510r CenturvLink Owest Corporation
230471 ;nturyLink Central Telephone Co.-North Carol ina(FKA Embar
330934 lenturvLink CenturvTel of the Midwest-Wisconsin (Northwest
230470 lenturyLink Carolina Telephone and Telesraph Co FKA Embar
4tt3t7 enturyLink United Telephone Co-Eastern Kansas (FKA Embar
33093 I Centurylink CenturyTel of Southern Wisconsin LLC
462208 CenturvLink CenturvTel of Colorado Inc.
341057 Centurvlink Gallatin River Communications LLC
371595 Centurvlink United Telephone Co. of the West GKA Embaro
2s0298 CenturvLink Gulf Teleohone Comoanv
280458 Centurylink CenturyTel of North Mississippi Inc.
310702 CenturyLink CenturyTel of Michigan Inc.
401143 CenturyLink CenturyTel of Russellville
401142 Centurylink CenturyTel of Russellville
429786 CenturvLink CenturvTel of Missouri LLC
429787 CenturvLink CenturvTel of Missouri LLC
330950 Centurylink CenturyTel of Northwest Wisconsin LLC
429784 Centurylink CenturyTel of Missouri LLC
429785 CenturvLink CenturvTel of Missouri LLC
Approved by OMB
3060-08 r 9FCC Form 555
December 2013
Affiliated ETCs
SAC Name
330956 Centurvlink CenturvTel of Northem Wisconsin LLC
401144 CenturyTel of Mammoth Sprins Jacksonville
3 I 0689 CenturyLink CenturyTel of Upper Michigan Inc.
330959 JenturyLink CenturyTel of the Midwest-Wisconsin (Northwest
300630 CenturvLink CenturyTel of Ohio Inc.
s05 I 07 CenturvLink Owest Corooration
160138 enturvlink United Telohone Co. of New Jersev (FKA Emban
270423 Centurylink CenturyTel of Central Louisiana LLC
4t1957 CenturyLink-Embarq Missouri Inc (FKA Embarq)
270427 CenturvLink CenturvTel of Chatham LLC
270424 Centurvlink CenturvTel of Southeast Louisiana LLC
330970 lenturvlink CenturvTel of the Midwest-Wisconsin (Northwest
270431 CenturyLink CenturyTel of Northwest Louisiana Inc.
3 I 0705 Centurylink CenturyTel of Northern Michigan Inc.
290574 CenturyLink CenturyTel of Ooltewah-Colleedale Inc.
270434 CenturvLink CenturvTel of Evaneeline LLC
310671 CenturvLink CenturvTel of Midwest-Michiean Inc.
270436 Centurvlink CenturvTel ofNorth Louisana LLC
270439 Centurylink CenturyTel of Rineeold LLC
270440 Centurylink CenturyTel of East Louisiana LLC
5l 1595 CenturyLink United Telephone Co. of the West (FKA Embarq
270442 CenturyLink CenturyTel of Southwest Louisiana LLC
290567 CenturyLink United Telephone-Southeast Inc. (FKA Embarq)
259789 CenturyLink CenturyTel of Alabama (Northern and Southern)
259788 CenturvLink CenturvTel of Alabama (Northern and Southern)
30066 l Centurylink United Telephone Co. of Ohio FKA Embarq
355 I 4l CenturyLink Qwest Corporation
42tt5l Centurylink Spectra Communications Group LLC
170209 lenturvlink United Telephone Co. of Pennsylvania FKA Emba
361445 CenturvLink CenturvTel of Minnesota Inc.
495 105 CenturvLink Owest Comoration
220356 Centurvlink Coastal Utilities Inc.
2905s2 CenturyLink CenturyTel of Adamsville Inc.
290557 CenturvLink CenturyTel of Claiborne Inc.
320832 CenturyLink United Telephone Co. of Indiana (FKA Embarq)
361456 CenturyLink - Embarq Minnesota Inc (FKA Embarq)
395145 CenturvLink Owest Corporation
552223 CenturvLink CenturvTel of the Gem State (Nevada)
240s06 enturyLink United Telephone of the Carolinas-SC (FKA Emba
522400 :nturyLink United Telephone Co of the Northwest(FKA Embar
2t0341 CenturyLink-Embarq Florida Inc. (FKA Embarq)
492274 CenturyLink CenturyTel of the Southwest (New Mexico)
522410 Centurvlink CenturvTel of Cowiche Inc.
522408 Centurvlink CenturvTel of Washineton Inc.
Approved by OMB
3060-08 I 9FCC Form 555
December 2013
Affiliated ETCs
SAC Name
482249 Centurvlink CenturvTel of Montana Inc.
411842 CenturyLink United Telephone Co. - Kansas (FKA Embarq)
t90254 CenturyLink Central Telephone Co. of Virginia (FKA Embarq
421957 CenturyLink-Embarq Missouri Inc (FKA Embarq)
532361 yTel of Eastern Oregon Inc.,CenturyLink CenturyTel of Oreg<
351126 CenturyLink CenturyTel of Chester Inc.
472223 CenturyLink CenturyTel of the Gem State (Nevada)
525161 CenturyLink Qwest Corporation
462187 CenturyLink The El Paso CounW Telephone Company
33084 I lenturylink CenturvTel of the Midwest-Wisconsin (Northwesl
462185 Centurvlink CenturvTel of Easle Inc.
375143 Centurylink Owest Comoration
512299 CenturyLink CenturyTel of Wyoming Inc.
442114 Centurylink Central Telephone Co. of Texas FKA Embarq
330857 lenturyl-ink CenturyTel of the Midwest-Wisconsin (Northwest
385 144 CenturvLink Owest Comoration
4421t7 CenturvLink CenturvTel of Port Aransas Inc.
475162 Centurylink Owest Comoration
320801 Centurylink CenturyTel of Odon Inc.
472225 Centurylink CenturyTel of Idaho Inc.
330877 CenturyLink CenturyTel of Fairwater-Brandon-Alto LLC
532400 lnturyLink United Telephone Co of the Northwest(FKA Embar
442140 CenturvLink CenturvTel of San Marcos Inc.