20140701Inland Telephone FCC Form 481.pdf

INLAND TELEPHONE COMPANY
Corparate O{fices
103 S. 2nd St.
P.O. Bax 171
Roslyn, WA 98941
RECil\/[:llj
20llr JUL - | il{ 9: Lf}
INLAND
TELEPHANE
Telephone: FAq 649-221 1
Fax: [phone]
June 30,2OL4
Via electronic filing to : [e-mail]
Ms. Jean Jewell
Commission Secreta4r
Idaho Public Utilities Commission
472 West \Mashington Street
Boise, ldaho 83720
GNR-T tLl- o I
RE: 2013 Eligible Telecommunications Carrier (ETC) Annual Reporting
Requirements with the IPUC
Dear Ms. Jewell:
Inland Telephone Company ("the Company") hereby provides copies to
the Idaho Fublic Utilities Commission ("Commission") of the filing to the
Federal Communications Commission ('FCC') and the Universal Service
Administrative Corporation ("USAC") for designation as an Eligible
Telecommunications Carrier, in accordance with 47 U.S.C. 54.313 and 54.422.
I have also included the signed Affidavit pursuant to Commission Order
2984I. Company, Study Area Code 472423, is a rural incumbent local
exchange carrier [LEC) as designated by the FCC, and is eligible to receive
federal universa-l service high-cost support pursuant to the Code of Federal
Regulations ("CFR"), Title 47, Sections 54.301, 54.305, and Part 36, sub-part F.
Please review the attached filing and include Company in your Annual
Use Certification Letter to USAC and the FCC. lf you have any questions, do
not hesitate to contact me directly.
Sincerely,
Enclosures
Treasurer/Controller
STATEMENT REGARDING OPERATING PROCEDURES
IMPLEMENTING 47 C.F.R PART 64 SUBPART U
GOVERNING USE OF
cusToMER PROPRIETARY NETWORT( TNFORMATION (CPN[)
MARCH 1,2014
The following statement explains how the operating procedures of Inland Telephone
Company ("Inland" or "Company'') ensure that it is in compliance with the Commission's CPNI
rules, as codiFred at 47 C.F.R. Part 64 Subpart U ($$ 64.2001-64.2011) and is relevant to
calendar year 2013. Except as otherwise indicated, the following applies with respect to the
Commission's rules in effect both before and after the December 8, 2007 effective date of the
Commission's April 2,2007 Report and Order in CC Docket No. 96-115. See FCC O7-22 (rel.
Apr. 2, 2007); Public Notice, DA 07-4915 (rel. Dec. 6, 2007). This statement covers calendar
year 2013.
L Use of customer proprietary network information without customer approval.
A. Inland may use, disclose, or permit access to CPM for the purpose of providing or
marketing service offerings among the categories of service to which the customer already
subscribes from Inland, without customer approval.
B. Inland may not use, disclose, or permit access to CPM to market to a customer,
service offerings that are within a category of service to which the subscriber does not already
subscribe from Inland, unless Inland has customer approval to do so, except as described in
Section I.C.
O) Inland may use, disclose or permit access to CPM derived from their
provision of local exchange service or interexchange service, without customer approval,
for the provision of CPE and information services, such as call answering, voice mail or
messaging, voice storage and retrieval services, and fax storage and retrieval services.
(2) Inland may not use, disclose or permit access to CPM to identify or hack
customers that call competing service providers except for CPNI made available to other
telecommunications carriers pursuant to tariffed or detariffed billing and collection
iurangements and billing and collection services provided pursuant thereto. The
Company does not sell CPNI to any third-party for any purpose.
C. Inland may use, disclose, or permit access to CPNI, without customer approval, as
follows:
(l) Inland may use, disclose, or permit access to CPM, in its provision of
inside wire installation, maintenance, and repair services.
(2j Inland may use CPNI to market services formerly known as adjunct-to-
basic services, such as, but not limited to, speed dialing, computer-provided directory
assistance, call monitoring, call tracing, call blocking, call return, repeat dialing, call
tracking, call waiting, caller I.D., call forwarding, and certain Centrex features.
D. lnland may use, disclose, or permit access to CPM to protect Inland's rights or
property; to protect its users and other carriers from fraudulent, abusive, or unlawful use of, or
subscription to, Inland's services; and to render, provision, bill or collect for services.
Inland provides local exchange telephone seruice and access to long distance service
providers rn srx exchanges in the states of ldaho and Washington. Inland's operatiug
prccedures corttply rvith the above requirements ottd ittclude, but are not liaited to, the
provisiorts rlescribed below. The Contpotty does not engage iu any outbortttd telemarketing.
Otrtbottrtd print nrurketing, ,f ony, that may be distributed by the Contpaty by nmil is
addressed to all subsuibers or customers withirt the opplicable geographic area, zip code(s)
and/or telephone number prefix(es), witltout regard to the speciftc services that the subscriber
or arstoruer receives, or does not receive, from the Contpany ond/or the Contpany's affiiates,
Under Company policy, rrote of the Company's alliliates is pernitted to use any CPNI of tlrc
Contpanyfor any outbouud telemarketing or outbortttd print marketing.
Moreover, the Cowpany does ,tot use any CPNI for auy irtbourtd marketing of services
that are not within a category of service (i.e.r local and interatchange) to which the astoruer
already suhscribes from lhe Contpany antUor orre or more of the Company's affiliates. The
Company does nol sell, or provide access to orry third pafi to, ony of the Contpany's CPNIfor
purposes of marketing the services of the Company or of any of its afftliates, other than as
pernitted without prior custonter opproval with respect to the Courpany's alftliates, Except for
CPNI made available to other lelecommunications caruiers pursuafit to tariffed or detardfed
ltillirtg and collectiott flrrailge,rtents and billing and calleclion services provided pursuant
thereto, aucl purntant to Comnrissiou-mandated carrier chnnge procedures, the Conrpatty does
not provide CPNI to any third-partyfor finy purpose.
The Company, its enrployees and agents may uake suclt other uses and disclosures of,
and permit aceess to, CPNI xtitltout customer approval as are perrnitted by applicable stalate,
rule, regulation or order. Such uses, disclosures or access nrcy lnclude those authorized by
Sectiotts 222(c) aud (d) of the Communicatiotts Act of 19i4, as anended, by Section 64.2005
of the Coumission's rules nncl by orders of the Commission.
Except as set forth above, the Contparry daes not provide any CPNI to arry
goverfirtterttal entitlt, or to any other third pa@, other than: pilrsuartt to sttbpoena or othet
lawfiil process or witlt the subscriber's prior written cofisertt, or in accordance with the
outlrcnticatiott ortd other requireatent described at Section IY below and in the FCC's rales,
as a result of a person represeutirtg himself or herself to be the subscriber (or the subscriber's
duly authorized ogent) and having confirued his or her identity or authority by provitlirtg to
the Contpany appropriate identifyirtg information (such as Social Security Nuntber, driver's
license number, ntother's nniden ilArrre, userutante or password, as nppropriate or othenpise
required).
II. Approval required for use of customer proprietary network information.
A. Inland may obtain customer approval through written, oral or electronic methods.
(1) Inland does not seek or obtain oral approval, and therefore does not bear
the burden of demonstrating that such approval has been given in compliance with the
FCC's rules.
(2) A cnstomer's approval or disapproval obtained by Inland to use, disclose,
or permit access to the customer's CPNI, the use of CPNI outside of the customer's total
service relationship with Inland must remain in effect until the customer revokes or limits
such approval or disapproval.
(3) Inland must maintain records of notification and approval, whether oral,
written or electronic, for at least one year,
B. Use of Opt-Out and Opt-In Approval Processes.
(1) Except where use, disclosure, or access to CPNI is otherwise permitted
withor.rt prior customer approval (as described above), Inland only uses, discloses or
permits access to CPNI upon opt-out or opt-in approval, consistent with Section 64.2007
of the Commission's nrles and, by December 8, 2007, with the Commission's amended
rules. Inland's process is described in Section II.A above.
(2) Except for use and disclosure of CPM that is penilitted wiflrout customer
approval under Section I, or that is described Section II.B, or as otherwise provided in
section 222 of the Communications Act of 1934, as amended, Inland may only use,
disclose, or permit access to its customer's iadividually identifiable CPM subject to opt-
in approval.
The Compafly curreiltly does not use CPNI in a manner that requires prior
custorrrer approval. Should luland's policy change, however, Iuland shall inrylement
the foregoing policies to e,tsure the FCC'I rules are coatplied with.
III. Notice required for use of customer proprietary network information.
A. Notification, GenerallY.
(1) Prior to any solicitation for customer approval, Inland must provide
notification to the customer of the customer's right to restrict use of, disclosure oi and
access to that customer's CPM.
Q) Inland must maintain records of notification, whether oral, written or
electronic, for at least one year.
B. Individual notice to customers must be provided when soliciting approval to use,
disclose, or permit access to customers' CPM.
C. Content of Notice.
Customer notification must provide sufficient information to enable the customer to make
an informed decision as to whether to permit Inland to use, disclose, or permit access to, the
customer's CPM.
(1) The notification must state that the customer has a right, and lnland has a
duty, under federal law, to protect the confidentiality of CPNI.
(2) The notification must specify the types of information that constitute
CPM and the specific entities that will receive the CPNI, describe the purposes for which
CPNI will be used, and inform the customer of his or her right to disapprove tbose uses,
and deny or withdraw access to CPNI at any time.
(3) The notification must advise the customer of the precise steps the
customer must take in order to grant or deny access to CPM, and must clearly state that a
denial of approval will not affect the provision of any services to which the customer
subscribes. However, Inland may provide a brief statement, in clear and neutral language,
describing consequences directly resulting from the lack of access to CPM.
(4) The notification must be comprehensible and must not be misleading.
(5) If written notificatiou is provided, the notice must be clearly legible, use
sufficiently large type, and be placed in an area so as to be readily apparent to a customer.
(6) If any portion of a notification is translated into another language, theu all
portions of the notification must be translated into that language.
(7) Inland may state in the notification that the customer's approval to use
CPNI may enhance Inland's ability to offer products and services tailored to the
customer's needs. Inland also may state in the notification that it may be compelled to
disclose CPNI to any person upon affirmative written request by the customer.
(8) Inland may not include in the notification any statement attempting to
encourage a customer to freeze third-party access to CPM.
(9) The notification must state that any approval or denial of approval for the
use of CPNI outside of the service to which the customer already subscribes from Inland
is valid until the customer affirmatively revokes or limits such approval or denial.
(10) lnland's solicitation for approval must be proximate to the notification of a
customer's CPNI rights.
D. Notice Requirements Specific to Opt-Out.
Inland must provide notification to obtain opt-out approval through elecftonic or written
methods, but not by oral communication (except as provided in paragraph F of this section). The
4
contents
sectioll.
of any such notification must comply with the requirements of paragraph C of this
(1) Inland must wait a 30-day minirnum period of time after giving customers
notice and an opportunity to opt-out before assuming customer approval to use, disclose,
or pennit access to CPNL Inland may, in its discretion, provide for a longer period.
Inland must notiff customers as to the applicable waiting period for a response before
approval is assumed.
(0 In the case of an electronic form of notification, the waiting period
shall begin to run frorn the date on which the notification was sent; and
(ii) In the case of notification by mail, the waiting period shall begin to
run on the third day following the date that the notification was mailed.
(2) [nsofar as Inland is using the opt-out mechanism, it must provide a Notice
to its customers every two years.
(3) If Inland uses e-mail to provide opt-out notices, it must comply with the
following requirements in addition to the requirements generally applicable to
notification:
(i) lnland must obtain express, verifiable, prior approval from
consumers to send notices via e-mail regarding its service in general, or CPM in
particular;
(iD Inland must allow customers to reply directly to e-mails containing
CPNI notices in order to opt-out;
(iii) Opt-out e-mail notices that are returned to lnland as undeliverable
must be sent to the customer in another form before Inland may consider the
customer to have received notice;
(iv) Inland must ensure that the subject line of the message clearly and
accurately identifies the subject matter of the e-mail; and
(v) lnland must make available to every customer a nrethod to opt-out
that is of no additional cost to the customer and that is available 24 hours a day,
seven days a week. Inland may satisff this requirement through a combination of
methods, so long as all customers have the ability to opt-out at no cost and are
able to effectuate that choice whenever they choose.
E. Notice Requirements Specilic to Opt-In.
Inland may provide notification to obtain opt-in approval through oral, written, or
electronic methods. The contents of any such notification must comply with the requirements of
paragraph C of this section.
F, Notice Requirements Specific to One-Time Use of CPM.
(l) Inland may use oral notice to obtain limited, one-time use of CPM for
inbound and outbound customer telephone contacts for the duration of the call, regardless
ofwhether Inland uses opt-out or opt-in approval based on the nature of the contact.
(2) The contents of any such notification must comply with the requirements
of paragraph C of this section, except that Inland may omit any of the following notice
provisions if not relevant to the limited use for which krland seeks CPNI:
(i) Inland need not advise customers that if they have opted-out
previously, no action is needed to maintain the opt-out election;
(ii) Inland need not advise customers that flrey may share CPM with
their affiliates or third parties and need not name those entities, if the limited
CPNI usage will not result in use by, or disclosure to, an affiliate or third party;
(iir) Inland need not disclose the means by which a customer can deny
or withdraw future access to CPM, so long as Inland explains to customers that
the scope of the approval Inland seeks is limited to one-time use; and
(iv) Inland may omit disclosure of the precise steps a customer must
take in order to grant or deny access to CPM, as long as Inland clearly
communicates that the customer can deny access to his CPM for the call.
The Contpaay currently does not use CPNI in a manuer that requires prior
atstonrcr approval. Shonltl hiland's policy change, however, Iulond sltall implement
tlrcforegoitrg policies to errsure the FCC'v rules are contplied x'itlt.
ry. Safeguards required for use and disclosure of customer proprietary network
information.
A. lnland must implement a system by which the status of a customer's CPNI
approval can be clearly established prior to the use of CPM. lnland's policies and procedures
are detailed in Section II above.
B. Eflective December 8,2007,Inland may release call detail information during a
customer initiated telephone contact only if reasonable authentication procedures are complied
with and (l) the customer provides Inland with a pre-established password, (2) Inland, at the
customer's request, sends the call detail information to the customer's address of record provided
the address of record has been associated with the account for at least thirty (30) days, or (3)
when Inland calls the telephone number of record to disclose the call detail infonnation. Inland
is permitted to create a back-up customer authentication method for lost or forgotten passwords.
Inland is also prohibited from releasing call detail information during a retail visit without the
appropriate password or valid photo identification.
However, if the during a customer-initiated telephone contact, the customer is able to
provide without assistance from Inland personnel all of the call detail information necessary to
address a customer service issue (i.e., the telephone number called, when it was called, and if
applicable the amount charged for the call), then Inland personnel are permitted to proceed with
its routine customer care procedures.
C. Not later than June 8, 2008, Inland must authenticate a customer without readily
available biographical or account information prior to allowing the customer on-line access to
CPNI related telecommunication service account. Once authenticated, the customer may only
obtain on-line access to CPNI related telecommunications service account through a password.
D. Effective December 8, 2007, Inland is required to notiS customers immediately
when a password or back-up means of authentication for lost or forgotteu passwords, on-line
account, or address of record is created or changed. Such notification is not required when the
customer initiates service, including the selection of a password.
E. Business customers are exenrpt frorn the password requirements which became
effective December 8, 2007, if: the customer is contractually bound to lnland, is serviced by a
dedicated tnland account representative as the primary contact, and within the contract Inland is
responsible to address its CPNI obligations. If, at any point, the business customer must go
through a call center to reach a customer service representative, then the exemption does not
apply.
F. Inland kains its personnel as to when they are and are not auflrorized to use CPNI,
and Inland must have an express disciplinary process in place.
G. Inland must maintain a record, elechonically or in some other rnanner, of its own
and its affiliates' sales and marketing campaigns that use its customers' CPNI. Inland shall
maintain a record of all instances where CPM was disclosed or provided to third parties, or
where third parties were allowed access to CPM. The record must include a description of each
campaign, the specific CPNI that was used in the campaign, and what products and services were
offered as a part of the campaign. Inland shall retain the record for a minimum of one year.
H. Inland must establish a supervisory review process regarding its compliance with
the FCC's CPNI nrles for outbound marketing situations and maintain records of its compliance
for a minimum period of one year. Specifically, sales personnel must obtain supervisory
approval of any proposed outbound marketing request for customer approval.
I. Effective December 8, 2007,Inland rnust take reasonable measures to discover and
protect against attempts to gain unauthorized access to CPM, which may include encryption of
its databases. Inland must properly authenticate a customer prior to disclosing CPM based on a
customer-initiated telephone contact, on-line account access, or an in-store visit.
Inland must take measures to protect CPNI stored in its intemal databases from potential
unauthorized access, and evaluate and increase its security measures should it discover an
increase in attempts to gain access to unauthorized information.
J. Inland must provide written notice within five business days to the FCC of any
instance where the opt-out mechanisms do not work properly, to such a degree that consumers'
inability to opt-out is more than an anomaly.
(1) The notice shall be in the form of a letter, and shall include lnland's name,
a description of the opt-out mechanism(s) used, the problem(s) experienced, the remedy
proposed and when it will be/was irnplemented, whether the relevant state commission(s)
has been notified and whether it has taken any action, a copy of the notice provided to
customers, and contact information.
(2) Such notice rnust be submitted even if Inland offers other methods by
which consumers may opt-out.
I( Effective December 8, 2007, Inland has a general duty to first inform federal Iaw
enforcement agencies, followed up by notification to affected customers, after reasonable
determination of a breach of its customers' CPM.
(1) Inland must file an electronic notification to the United States Secret Service
(USSS) and the Federal Bureau of Investigation (FBI) within seven (7) business days
tluough the central reporting facility furnished by the Commission.
(2) Inland is prohibited from notiffing customers or the general public of the
breach until seven (7) business days have passed after notiflcation to the USSS and EBI
unless under certain specified circumstances: (a) Ialand identifies an "exEaordinary need
to notify customerso'before that period or O) An ongoing or potential investigation or
national security requires customer disclosure to be potentially delayed for up to thirfy
(30) days. Inland must notiff the affected customer(s) after the applicable period.
(3) Inland must maintain a record, whether electronically or in some other manner of
any breaches discovered, notifications made to the USSS or FBI and notifications made
to customers. The record must include, if available, dates of discovery and notification, a
detailed description of the CPNI that was the subject of flre breach, and the circumstances
of the breach. Records must be maintained for a two (2) year period.
fnhnd's operatilry procedures coutply ryith all of the obove requirements, irtclrtdiltg
those that becanrc effective Decemher 8, 2007. With respect to ortline authentication ilt
particular,Inland implemented ,rteasures to etsure contpliance by the applicable June 8, 2008
deadline. As previottsly discussed, the Company currently does not use CPNI in a manner
tlut requires prior castomer approval. Slnald Inland's policy change, howeverr lnlaud shall
implentent the relevant aforententioned policies to ensure the FCC's niles are contplied x,itlt.
Inlanrl notes iil particular that:
t Contpafly personrrel ore truined as to xtheil they are and ore not authorized to use
CPNI, and that oil eJcpress process is in place such that uiolations of these procedures
may reuilt iu disciplirtary actiott, ttp to and including terminatiort of employment.
o Inlond does not provide custonrers' witlt onlinc access to their CPNI at this tilne.
. ll/itlt respect to business crtstomers subject ta Section IV.E above, hilsrrd requires theut
to provide the names of all tlrut are sulhorized to have access to the accourrt and at
what authorization level (eg. to make service changes, request additional services,
billittg fuquiries) and further requires tlut a 6 to l0-plnce alphanunrcric pasxvord be
established.
e Operutilry procedures have been hnplemented to cotttply with the remaining
requirements described above aud applicable to Inland's use, disclosure of and third
party access to CPNL
V. Supplemental Information
Effective December 8, 2007, the FCC's rules require that the annual certification filed
pursuant to 47 C.F.R. $ 64.2009(e) disclose any actions taken against data brokers and a
sunmary of all consumer complaints received in the previous calendar year regarding the
unauthorized release of CPM. Inland is not aware of any consumer complaints regarding the
unauthorized release of CPM and has not taken action against any databrokers.
INLAND TELEPHONE COMPANY
103 S. 2ND Street
P.O. Box 171
Roslyn, WA 98941
l509l 649-2211; (8Ool a62-a578
Fax [phone]
CERTIFICATION BY CUSTOMER IN ORDER TO RECEIVE FEDERAL LIFELINE SUPPORT
STATE ELIGIBILITY (Subscriber signature not required)
I certify that I am qualified through the:
E Community Action Partnership Association of ldaho (CAPAI) (lnland must receive email confirmation from CAPAI)
E Washington Department of Social and Health Services (DSHS) - Case #
(Must have o current Woshington DSHS Cose # ond porticipote in ot leost one of the programs below)
! Sunntemental Nutrition Assistance Program (SNAPXFood ! tre8nant Women Assistance (PWA)
Stamps)
I terporary Assistance for Needy Families (TANF)
! Sunnlemental Security lncome (SSl)
f] uedicaid (Medical Assistance)
I St.te Family Assistance (SFA)
INCOME ELIGIBILITY
I certify that my household income is at or below 135% of the federal poverty guidelines and therefore I qualify for Lifeline Support
under the federal income requirements and have provided proof of my qualifications.
FEDERAL ELIGIBILITY
I certify that I qualify for Lifellne Support and am currently participating in one or more of the programs listed that I have checked below and am
providing a copy of my benefit or program participation card or award letter.
Medicaid
Temporary Assistance for Needy Families (TANF)
(SNAP)(Food Stamps)
Low lncome Home Energy Assistance Program
(LIHEAP)
National School Lunch Program's free lunch program
trI
E
fl asea, Blind, or Disabled (ABD) Cash Assistance
I netr8"" Assistance
fl Corn*rnity Options Program Entry System (COPES)
Chore Services
E
E
n Supplemental Nutrition Assistance Program
Federal Public Housing Assistance (FPHA) or
Section 8
E Supplemental Security lncome (5Sl)
TRIBAL LIFELINE ELIGIBILITY Tribal ldentification Number
I certify that I qualify for tribal Lifeline Support, as I reside on land that meets the Bureau of lndian Affairs definition of "reservation" (any federally
recognized lndian tribe's reservation, Pueblo, or Colony including former reservations in Oklahoma, Alaska Native regions, and lndian Allotments)
Nq participate in one or more of the programs listed that I have checked below and am providing a copy of my benefit or program participation
card or award letter.
trl Supplemental Nutrition Assistance Program
Federal Public Housing Assistance (FPHA) or
Section 8
(SNAP)(Food Stamps)
Low lncome Home Energy Assistance Program
(LIHEAP)
National School Lunch Program's free lunch program
Head Start (lncome eligible)
Medicaid
Bureau of lndian Affairs General Assistance
Tribal Administered Temporary Assistance for Needy Families
(TTANF)
Temporary Assistance for Needy Families (TANF)
Food Distribution Program on lndian Reservations
Supplemental Security lncome (SSl)
lncome Eligibility (See lncome Elieibility)
trI
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E
E
E
EEtl
SUBSCRIBER CERTIFICATION
It is understood that by participating in the Lifeline program, the support that I receive is not actual payment to me but a discount on my monthly
billed service. Participating in Lifeline does not protect me from collection procedures if I do not pay my phone bill. lfully understand that this
discount, as well as the criteria for participation in the Lifeline Program, may change and I may no longer qualify, or the amount of support may
increase or decrease.
Filename: 140603 APPLICATION - BY EXCHANGE.xlsx LIFELINE CERTIFICATION Page 1 of 3
As the Certifying Subscriber, I certify that, (i) the service is for me and not a member of the household; (ii) I am not listed as a dependent on
someone else's tax return; and, (iii) the service address is my primary residence. I further certify that the service that I receive from lnland
Telephone Company is my main line of service and neither I nor anyone in my household receives Lifeline Support for any other
telecommunications service. Further, I understand that Lifeline is a federal benefit program that provides a monthly discount on either home or
mobile telephone service and ONLY ONE Lifeline discount is allowed per household. Members of a household are not permitted to receive Lifeline
Supportfrommultipletelecommunicationscompanies. lunderstandthatviolationoftheone-per-householdrequirementwill resultinde-
enrollment from the program and possible fines and imprisonment. As the Certifying Subscriber claiming income eligibility, I certify that the
documentation I have provided accurately represents: (i) my household income and the number of persons in my household; or, (ii) proof of
participation in an eligible program.
I certify that I will notify lnland Telephone Company within 30 days,(i) if for any reason I should no longer participate in any of the eligible programs or qualify
by income, and or (ii) if I move from the address provided on this form. lf my address listed above is temporary, I certify that I will verify my address to lnland
Telephone Company every 90 days. I understand that if I fail to respond to an attempt to verify my address within 30 days, my Lifeline support may be
terminated. I understand that if I fail to give notice as required, I am subject to penalties, including de-enrollment, being barred from the program and fines
and imprisonment.
I understand that Lifeline Support is not transferrable and that I may not transfer my service to any individual, including another eligible Lifeline Support
recipient. I further understand that if my service goes unused for 60 days, my service will be suspended subject to a 30 day period in which I may use the
service or contact lnland Telephone Company to confirm that I want to continue receiving the service.
Further, I fully understand that in order to continue to receive thls support, I must annually, or more often, certify my eligibility and provide proof of eligibility.
I understand that my failure to timely re-certify will result in de-enrollment and termination of my Lifeline benefits.
I fully understand that the Lifeline Program is administered by the Universal Service Administration Company (USAC) under the guidance and
authority of the Federal Communications Commission (FCC)and that all of the information that I have supplied pertaining to my eligibility will be
shared with USAC and the FCC and I give my consent to do so.
I certify that the information provided on this form is true and correct to the best of my knowledge under penalty of perjury and if I have provded
any misleading statements in orderto receive support, lwill be liable for any support received, my service may be discontinued, it may result in de-
enrollment and my being barred from the program and I would be subject to state and federal fines and imprisonment.
SIGNATURE OF APPLICANT
APPLICANT (PRINTED)
SOCIAL SECURITY NUMBER
SERVICE ADDRESS
xxx-xx-DATE OF BIRTH
BILLING ADDRESS
TELEPHONE NUMBER
lnland Telephone
NUMBER OF PERSONS IN FAMILY OR HOUSEHOLD
ial, except as ALT INFORMATION
Company service - Customers serving Exchange
DEWATTO, WA
PRESCOTT, WA
ROSLYN, WA
NAME OF CUSTOMER SERVICE REPRESENTATIVE
COMPTETED ON THIS FORM IS SUSJECT TO STATE AND FEDERAI. PERJURY PENALTIES.
Filename: 140603 APPLICATION - BY EXCHANGE.xIsx LIFELINE CERTIFICATION Page 2 of 3
I NLAND TELEPHONE COMPAiIY
(5091 649-2211; (8OOl 462-4578
Fax [phone]
LIFELINE HOUSEHOLD WORKSHEET
Your household is everyone who lives together at your address as one economic unit (including children and people who are not related to you).
Theadultsyoulivewitharepartofyoureconomicunitiftheycontributetoandshareintheincomeandexpensesofthehousehold. Anadultis
any person 18 years of age or older, or an emancipated minor (a person under age 18 who is legally considered to be an adult). Household
expenses include food, health care expenses (such as medical bills) and the cost of renting or paying a mortgage on your place of residence (a
houseorapartment,forexample) andutilities(includingwater,heatandelectricity). lncomeincludessalary,publicassistancebenefits,social
security payments, pensions, unemployment compensation, veteran's benefits, inheritances, alimony, child support payments, worker's
compensation benefits, gifts, and lottery winnings
Spousesanddomesticpartnersareconsideredtobepartofthesamehousehold. Childrenundertheageof 18 livingwiththeirparentsor
guardiansareconsideredtobepartofthesamehouseholdastheirparentsorguardians. lfanadulthasnoincome,orminimal income,andlives
with someone who provides financial support to that adult, both people are considered part of the same household.
You hove been osked to complete this Worksheet becduse someone else currently receives o Liteline-supported service ot your address. This
other percon may or may not be o port ol yout household. Answer the questions helow to determine whether there is more thon one
household residing at your address,
1) Does your spouse or domestic partner (that is, someone you are married to or in a relationship with) already receive a Lifeline-discounted
phone? (check NO if you do not have a spouse or partner)' lvrs E*o
> lf you checked YES, you may not sign up for Lifeline because someone in your household already receives Lifeline. Only ONE Lifeline discount is
allowed per household.
> lf you checked NO, please answer question #2.
2l Other than a spouse or partner, do other adults (people over the age of 18 or emancipated minors) live with you at your address?
flves E*o
[ves E*o
A. A parent
B, An adult son or daughter
c. Another adult relative (such as a sibling, aunt, flves Ero
cousin, grandparent, grandchild, etc..)
O. An adult roommate
E' other Jtrt Ero
> lf you checked NO for each statement above, you do not need to answer the remaining questions. Please initial line B, below, and sign and date the
worksheet.
> lf you checked YES, please answer question #3.
3) Do you share living expenses (bills, food, etc.) and share income (eitheryour income, the other person's income or both incomes
together) with at least one of the adults listed above in question #2?[vrs fl*o
>lfyoucheckedNO,thenyouraddressincludesmorethanonehousehold. Pleaseinitial linesAandBbelow,andsignanddatetheworksheet.
> lfyoucheckedYEs,thenyouraddressincludesonlyonehousehold. YoumaynotsignupforLifelinebecausesomeoneinyourhouseholdalready
receives Lifeline.
CERTIFICATION
Please initiol the certification below ond sign ond date this worksheet which must occompony your Lifeline opplicotion.
A. I certiJy thot I live at an oddress occupied by multiple households.
B. I understond thdt violotion of the one-per-household requirement is agoinst the Federol Communicotions Commission's rules ond moy
result in me losing my Lifeline benefits, ond potentially, prosecution by the United Stotes Government.
SIGNATURE
[ves E*o
Filename: 140603 APPLICATION - BY EXCHANGE.xISx LIFELINE CERTIFICATION
DATE
Page 3 of 3
Form 481 - Carrier Annual Reporting
tCC Form 481
CIMB Gontrel No. 3O6{Xr!rE5lOMB Co.tol tto. 30€GO819
Juty m13
Page 1
<010> Studv Area Code
<015> Studv Area Name IN]]M TEL-ID
<020> Program Year 2 015
<030> Contact Name: Person USAC should contact
with questions about this data James K. Brooks
<035> Contact Telephone Number 50964922I1 ext
Number ot the identitied in data line <030>
<039> Contact Email Address:
Emall of the person identitied in data line <030> j brooks@inrandnet - com
REPORTING FOR ATL CARRIERS
5tt.313 ..' *.422
Completion I Completlon
<100>
<200>
<210>
<300>
<310>
Service Quality I mprovement Reporting
Outage Reporting (voice)
( com plete ottoched wotksh ee t)
(.om plete ottoched wotk5h eet)
(check box when conptete)
l-h.--.heck box rf noF-{
<320>
<330>
Unfulfilled Service Requests (voice)
Detail on Attempts (voice)
Unfulfilled Service Requests (broadband)
Detail on Attempts (broadband
(otto ch descil ptive docum en t)
I o ttoch descriotive document)
<410>
<420>
<430>
<440>
<450>
<500>
<400> Number of Complaints per 1
Fixed
Mobile
Number of Complaints per 1,000 customers (broadband)
Fixed
Mobile
Service Quality Standards & Consumer Protection Rules Compliance
74a630 412423 CERTIFICATIONS.pdf, 7442L2 ITC 802299 CPNI
CERTIFICATION.pdt, 140212 lTC 802299 CPNI OP PROCEDURES.pdf
<510>
Situations
(voice)
Terrestrial Backhaul (Y/N)?
Terms and Condition for Lifeline Customers
(compl ete attoch ed w otksheetl
(compl ete ottoch ed wotksheetl
(@mpl ete ottoch ed w otksheet)
(if yes, conplete atto.hed worksheet)
(chpck to indicote cettllicotion)
desctiplive doumentl
(otta ch desctiptive docum en t)
77
l/]7
0.0
00 I , h*m*u
77(check to indicote cettilicotion)
( o ttoch ed des ci pti ve docum ent)
(check to indicote certificotion)
<510>
<700>
<7to>
<800>
<900>
<1000>
<1010>
<1100>
< 11 10>
<1200>
Company Price Offerings (broadband)
Operating companies and Affiliates
Tribal Land Offerings (Y/N)? O OVoice Services Rate Comparability
(ifnot, check to indicote certilicotion)
( conpl ete ottoch ed worksheet)
(compl ete attoch ed w otksh eet)
<2000>
<2005>
<3000>
<3005>
Price Cap Carriers, Proceed to Price Cap Additional Documentation Worksheet
lncluding Rote-of-Return Corriers offilioted with Price Cop Locol Exchqnge Corriers
(check to indicote cettiJicotion)
(compl ete o tta.hed workshe etl
Rate of Return Carriers, Proceed to ROR Additional Documentation Worksheet
(check to indicote certilicotion)
(conplete aftoched worksheet)
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Page 12
<010> Study Area Code 412423
<o15> Studv Ar.a Name INI,AND TEL-ID
<020> Proqram Year 20rs
<030> Contact Name - Person USAC should contact reEardinr this data James l(. Brooks
<035> ContactTelephoneNumber-Numberofpersonidentifiedindataline<030> 5096492211 ext.
<039> Contact Email Address - Email Address of person identifird in data line <030> jbrooks@inlandnet . com
TO BE COMPTETED BY THE REPORTING CARRIER, lF THE REPORTING CARRIER IS FILING ANNUAT REPORTING ON ITS OWN BEHATF:
Certification of Ofticer as to the Accuracy of the Data Reported for the Annual Reporting for CAF or u Recipients
cenify that I am an olficer ol the rcportlnt carriar; my responslbllltlas ltrclude ensudnt the.ccuracy ofthe annual rcportlnt rcquiremlnts for unly€rsal seruic€ support
eciplents; and, to the best ol my knowledte, th€ lnformation reported on this form and ln any attachments is accurate.
{ame of ReD 2 6...;".. INLAND TEL-ID
ofAuthoriredoffice. CERTTFTBD ONLTNE Date
)rinted namr ofAuthorized otficer: irames Brooks
'itle or posltion of Authorized officer: Treasulerlcortroller
elephone number of Authorized Off icer. 50 964 92 211 ext.
itudv Area Code of Reportins carrier: 412421 Filinr Due Dateforthisform' 0?/01/2014
Per$ns willtully mkint f"lsr datlmrnts on this form can be puni!h.d by fine or forf€ituE under the Communications Act of 1934, 47 U.S.C. 55 502, 503(b), or fine or imprisonmlnt
underTitle 18 ofthe Unitrd SEtls Code, 18 U.S.C. 5 1001.
Page 12
Page 13
-A8ent/Carrler FccForm4Sl
Collecdon Form OMB Contrcl No. 3O6OS86/OMB Control No. 305G@19
tr.f,, ,Ar r' JuV2013
<010> Studv Area code
<015> Study Area Name TNLAND TEL-ID
<020>2 015
<030> Contact Name - Person USAC should contact reEarding this data James K. Brooks
<035> ContactTelephoneNumber-Numberofpersohidehtifiedihdataline<030> 5096492211 ext
<039> Contact Email Address - Email Address of oerson identified in data line <030>
TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING ANNUAL REPORTS ON THE CARRIER'S BEHATF:
TO BE COMPLETED BY THE AUTHORIZED AGENT:
Certification of Officer to Authorize an Agent to File Annual Reports for CAF or Ll Recipients on Behalf of Reporting Carrier
certify that (Name of is authorlzed to submlt the information reported on behalf of the reporting carrier.I
lso certify that I am an otricer of the reporting carier; my responsibilities include ensuring the accuracy of the annual data reporting requiremnls provided to the authorized
gent; and, to the best of my knowledge, the rcpods and data provided to the authorized agent ls accurale,
,lame of Authorized Asent
,lame of Reoortins Carrier
e of Authorized officer Date
'rinted name of Authorized Officer
itle or oriz€d Offi.er
eleohone number of Authonzed Offrcer
itudv Area Code of ReDortinE Carrieri Filing Due Date for this form
underTitle 18 0fthe LJnated states code. 18 u.s c. 5 1001.
Certification of Agent Authorized to File Annual Reports for CAF or Ll Recipients on Eehalf of Reporting Carrier
he data reported herein based on data provided by the reporting carrier; and, to the best of my knowledge, the information reported herein is accurate.
Jame of Reportihg Carrie.
Jame of Authori2ed Fmnl6vep ofAEent
isnature of Authorized AEent or Emolovee of AEent Date
rinted name of Authorized Asent or Emolovee of Asent
itle or position ofAuthorized Asent or Emplovee ofAgent
number of Author;rFd As.nt of Apent:
;tudv Area Code of Reoortine Carrier Filins Due Date for this form
18 ofthe United Srates Code, 18 U.5.C. 5 1001.
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Ability to Remain Functional in Emergencies Gertification
554.313(axo)
EICs must demonstrate that it has a reasonable amount of back-up power to ensure functionality without
an extemal power source, is able to re-route tratfic around damaged facilities, and is capable of managing
traffic spikes resulting from emergency situations.
l, James K. Brooks, being of lavvful age, state that I am Treasurer/Controller of
lnland Telephone Company ("Company"), that I am authorized to execute this
certification on behalf of the Company, and that the facts set forth in this certification are
true to the best of my knowledge, information and belief.
On this basis, the Company certifies to the ldaho Public Utilities Commission,
pursuant lo 47 C.F.R. S 64.2009(e), that the Company's operating procedures are
adequate to ensure compliance with the Customer Proprietary Network lnformation
rules and regulations as set forth in 47 C.F.R. SS 64.2001 through 64.2009.
The Company is able to remain functional in emergencies as set forth in
Commission Order No. 29841 and in 47 C.F.R. 554.201 (a)(21, as such standards relate
to functionality of wireline carriers in emergency situations. The Company further
certifies that it maintains back-up power to ensure functionality without an external
power source in the forms of auxiliary generators and batteries in its central offices as
well as adequate battery back-up in its subscriber carrier cabinets and that its switching
capability is more than adequate to manage the traffic of its subscribers.
For calls within the exchange of Leon, depending upon where a cut is made,
there exists redundant toll routing however, the Lenore exchange has no redundant totl
routing. ln both exchanges, customers can continue to make calls within the exchange
should the interexchange interconnected facilities get disconnected. The Company
does not have ring technology at this time however; it is looking at redundant routing
altematives for Lenore.
I certify under penalty of perjury under the laws of the State of ldaho that the
foregoing is true and correct.
Dated this 30h day of June, 2014 atRoslyn, Washington.
By:
K. Brooks
Treasurer/Controller
lnland Telephone Company
tlcollcdo ofllfruioq
usoA.Rus
OPERAIING REPORT FOR
TELECOMMU NICATIONS BORROWERS
l?ah &uuill bc wd by RUS m alat prfuwrclol tiuador l'ow rqpou. b rquhd bl ? USC.90l ., tt1,,
ne a,hld b Ldal larr dl ,rflldtu ffiilhc alldarlal lnlomta iln h{ Mtd e dniadd!
IORROWER MME
Inland Telephore coq)any
(erepared with AudiEed DaEa)
'NSIRUCTIONS-.fflhnI. Eptt to Rl,lS \lrhln 30 rhy qltoclotc of ,hc pcid.
"or d.rollcd lEilEtlory, scc RUS Bullctla 1711-2. Rcport la \holc dolha only,
PERTOD ENDTNG IBORROWER DESTGNATTON
Decernber, 2013 lWA053rl
CERTIFICATION
lfc lurcby en{1' 1ls1 the awl6 h ,hls r€po|t aru lil adotdance wilh ,lre dffiwils and other rcards olthe $$ktn aod ,ttlecl rhc stalw of fic t),tt.m
to the bcsl ofour htowlcdgc and bcllef,,
ALL INSURANCE REQUTRED BY 7 CtrR PART 1788, CHATTER XVIT, RUS, WAS IN FORCE DURING TTIE RE,PORTING PERIOD AND
RENEWALS HAVE BEEN OTTAINED FORALL POLICIES.
ltuRtI{G'l'uripEIlroDcovElt!:l, llY'l'HlsR"]:l,oRIfullsuANl'luPAR'I'rTrEot 7c]RcHAl'l'ERxvll
(Cluch ffi olup lolowlngl
E A[ oI tha oblgadffr udu rha RUS bm dmJrncntt
haE b!€n ftrltt.d ln allnallrtrl Gplcls.I Thuc hro boon a detBu[ h lh! tuIfl[rnsnl ollll! oblgeuoru- uds irB Rt S lou doqm8nB. Sald d.faul(s) ls,ls€
ip.cJfialy dEqlbcd h lho Tdrcom Op6r6dng Rlpon
Greqorv Maras 3/20/2oL4
DATE
PART A" BALANCE SHEET
ASSETE
BALANCE
PNloR YEAR
BALANCE
EIN AF DFEI6 UABILITTES AND STOCI(HOLOERS' EOUITY
BAI-ANCE
DFIAP VE E
BALANCE
EIN AE DEEIM
:URREI{T ASSETS
l. Ce3h snd EouiElents
,, . :' r.,:, . ,,.ji,
565, 7s:
"'.': i'':,',,,rll::
298 ,4t
;URRETT LIABILMES
E. Acrount3Pavru€
|,,:::;-;1,1'.; i!, r,t,- :i., 1,'.''':. :::
t, L34,728
2 C$1Ff,IIJS CoEln ctlon Fund 8.04(395.811 E- NolEi Pewble 0
3. Ar{nlat€s::r;;:;;;;i) ;; iii,''1..,.,n.'jli.r 17- AdEm Blllnc ard Pamenls 0
s. Talecom. AccoJnlr RecaivEbls 82 , q2(a4,4A6 18. CuEtomgr Oopolit8 2, 09(2 .519
b, Olhet Account6 Rec€lvablo ts. CunEnt MsL UT Dobt 673,30(389,000
c Notas RecatvEb,e 0 10. Curent MeL UT DBbt-Rlf,. Dav.
4. Non.Ailllhts:11- Cumnt Met-.Cedlrl LBB 0
8. Tolocom, Accouni8 Rgcelvablo 453,381 635,441 12. lncome Tares AccnJsd 2(50,011
b. Other Accounts RecelvaHe 13. OtherTar6Accru€d 78, 55!L42.940
c. Not6s Rsc€lEblB 14, Othor Cunorll LlBbiUtiB 776,165 815, 571
5. lnlrot md DlvlCends Raelveblo 15. TotEl Cunont Lhbllllles {2!i thru 341 1.721 .375 2.544.749
0. Malerl8l.Rsaulsied 259 .616 269 ,54',.ONG.TERM DEET
18. Funded D€bhRUS Not63
. :, . ., ^"
363,004
'i r';.'u.1:il,:
23L,6757, Msls.iel-Nonrgold6tad
8. PEoavmEnts 2 ,49C 38,20I 17, Fundod DEbI-RTB Not6 198, 95C 65, 936
9. Olh€r Cumnl A$ats i8. FundldD€bt-FFBNolB 534,358 2 ,8L6 ,944
10. folrl CumntA.sst3 ll Thru 0l L,372,73C I ,722 . 90t i9. Furdad Dabt-Oth€r (2,65s)
NONCURREHT ASSETS
11. lnvostment in Amiatsd ComEnhs
::I 1 _.,:.'10. Fundad Debt Rural Deyelop. Loan 0
l. ftemlum (Dbcoun0 on UT oebt 0 0
a. Rural DEvdomnt 290,67)51,70!12. RescouirBdDob(0 0
b. NonruEl DaveloDreBl 13. OHioe0orE Unds Csohal Lsse 0
I 2- Olher I ruEtmenle lt.:8:t!..r, !.;,rl1r 14. Adv. Fmm Affillaled Cdmffinia 0
a, Rutel DwdoDmont 15. OlherLono.Tarm Oebt
b. Nonrural DeElosmnl L78,!2a 190, 105 16. Total Lono.Torm Dobt (36 thru asl L , O95 ,322 3,111,903
3. NomulaEd lffitrnenls 831.59(I . 821. 312 )THER UAB. A DEF. CRED]TS
17. Olhsl-opTm Lbblltles14- OIhs Nonarm! Asssb 2A(25A
i5- Dafered ChmB 18. OlhtrDefilr€d Crcdhg 7L6 ,5L2 528,L25
6. Jurlsdlctlonel Diftrsncas t9. Otts Jurtrdldlorol Dllteffi 0
7. Tolll NoncunsntA3ssE (11 thru 16)1. 3 00, 63{2,06X .377 i0. Total Olhor LlsbflUE End Dot md Credl6 (47 thru 49)1L6,6L2 528,126
'LANT. PROPERTY, AND EQUIPIIIEI{T
8. TdomDPlant.lnsnlG
,".'j:,:r! i, ,,. rt , r. ;' 1,,. r ti!.,r
' 1,,i,
22,848,576
:OUITY
i1. CeD. Sloch Outstsnd. & SuEdibed
I l '- l' ::.1
93,1502258{.411 93 x5(
9- Pmostv Hdd fur Fulurc LJss 0 i2. Addlllonal PaH]*Csoltal 7,t7!7 ,t7S
10. Plant Undsr Construdion 123.651 2,578,522 i3- Tlt8wstod(
11. Plant Adl., Nonoo. PlEnt & Gmdwlll i4. Membarshlosnd Cao, Cer{lhates
2. La3s Acarmdded Deracblhn ls.657.911 16. 940.466 i5. Olhercspitel 0 0
B. N6t Plant ll8 lhru 2l lu 221 7 ,250,L5',9,485.932 i6. Pslroneoe Csoitsl Cr€dlrts 0
la. TOTAL ASSETS (l0l17+23,
9 .924 .521 L2,271,2L7
i7. RetElned Eemlnos or MerclG 6-286-ACI 5_qEE-O?4
i8. Totrl Edultv a6l lhru 5rl an? 2nF 6. OnA - 1qq
19. TOTAL LIAB|LmES AND EqUITY (35+48+50+581
9,923,52r t2 , 273 ,217
A@6!irothcPrp@clRi*EdoiAdoflggJ,Dr3q.?dlyNt6drdartrow,DdrDdsoiruotttsitldhr6p6db.rollctdooofitrfffiionpnl6titditpllyt!ydldoMBElhlMb6. Thcvild
OilE ml rub6 hr t[t itrf@dor @lt6ria l, 052fl] I . ft. tinc Eqtrirtd to mpld, Ob infmlti@ @ll..d@ h 6rimltql lo !Erg. 4 lM p6 EspoB hdodng 6c tbc fB Bio'lng hffiloB,
Totsl Equity= 49.51t % orTotalAsssts Page 1 of 6
USDA-RUS
OPERATING REPORT FOR
TELECOMMU NICATIONS BORROWERS
BORROWER DESIGNATION
I{Ao534
PERIOD ENDING
Decedber, 2013'NSIRUCrTO^/$ Sea RUS Bullelln 1744-2
PART B. STATEMENTS OF INCOME AND RETAINED EARNINGS OR MARGINS
ITEM PRIOR YEAR THIS YEAR
1. Local Network SeMces Revanues 711,304 568.600
2. NetworkAccsss Servlces Revenues 4 ,720 ,821 4,213, 114
3, Lono Dlslance Network Services Rayenues 18,094 (788)
4. Canler Bllllno and Collec-tion Revenues 49, 017 55,958
5, Miscellaneous Revanues L09,474 52,553
6. UncollectibloREvenuss 4,796 6,212
7. NetOoerallno Revenuae (1 thru 5 lsss 6l 5,605, 915 {, 983 , 175
8. Plant Specltic Operallons Expense 2,24O,OzL 2,001,65i
9. Plant Nonsoeclllc Ooeratlons Exoensa (Erctudlno Deoreclation & Amorilzelionl 338, S50 333,31!
0. DeoreclellonExoense r.zss .27 4 1,315. 8?!
11. Amorllzallon Exoensa !42 18:
2. Cuslomsr Operatlom Expense 517, 858 549, 59!
3. Comorate Ooarations Exoansa 1, 032.592 1 , 011, 755
14. Total Opsradng Expengee (8 lhru ,3)5,384 ,757 5,213,39t
5. Ooerallno lncome or Mamlns (7 less 14)22r,729 1230,2231
18. Other Operallng lncome and Expenses 0
7. Stale and Local Taxes 110. 333 126,725
18. Federal lncome Taxes 998 ( 157, 5{?)
19. Oth€rTaxes 0 0
10. Total ODerallno Tsxes ll7+{8+l9l 131, 331 140 ,8221
11. Net Ooeratlno lncoma or Mamlns ll5+1&20)89. 798 (189, rl01)
12. lnierest on Funded Debt s5, 114 ?5 ,452
13. lnteGst Exoensa - CeDltsl Lasses 0 0
14. Olher lntersst Exo€nss 14, 555 19, 260
25. Allowence for Funds Used Durino Conslrucllon o 0
10. Total Flxed Charoes (22+23+21-251 99,769 94 ,7L2
17. Nonooerstlno Net lncome r7(l . 535 (r4,982)
28. Exkaordinarv ltems 0
19. Jurlsdlctlonal Differences 0
10. Nonr€oulatod Net lncome (513,?54)(3,308
11. Total Net lncoms or Marolns 121+27+28+29+38261 (349.099)1102 _ao1
12. Total Tares Basad on lncome l1?4.6381 1165.487
13. Retalned Eamlnos or Mamlns Beolnnino-of-Year 6.534 .486 6 - rn6. nE!
14. Miscsllanoous Credlts Year-io-Date 1 ,496 3, 594
t5. Divldends Declared (Common)0
l€. Dlvidends Daclared fPrefcned)o
17. Olher Deblts Year-to-Date o
18. Transfers to PatrorlBoe CaDllal 0
19. Retalned Eamlnos or ]llerolns End-of-Perlod 1{31+33+3tl} - (3t}36+37+38}t 6,285, 883 5,988, 07
10. Patronaoe Caoltral Beoinnino.of-Year 0
1. Transfers to Palronaoe Caollal 0
12. Palronaoe CaDitsl Credlls Retlred 0
L?. Patsonaoe CsDttal End.of.Yoar 140+41121 0
14. Annual Debt Servlce Pavmenls 7a7,181 780,059
15. Cash Ratlo I(14+20-10-111/n 0.7600 o.7737
16. ODeralino Accrual Rallo 1t14+20+2il I n 1 - 0018 1.0s70
17. TIER t(3'l+26) / 261 -2.499L -2.t929
18. DSCR t(31+26+10+'ll) l/l4l L.EOL?t.422t
Page 2 of 6
USDA.AUS
OPERATING REPORT FOR
TELECOMMUNICATIONS BORROWERS
,irSIRUCnO rS. S ee nUS auilenn lru+z
BORROWER I'ESIGMNON
wA0534
PERIOD ENDED
D€csmb€r.2013
Prr C. SIIBSCRIBER (ACCESS LINEL ROIJTE MILE. & ItrGIr SPEEII IIATA INFORMATIoN
I. RATES 3- nouTE iltLES
EXCHANGE B1 R-1
aht
BUSINESS RESIDENTIAL
,h\
TOTAL TOTAL(lnduding flber)
FIBER
)EWATTO 27.OO 2:LOt t!301 3lt taa.03 40-o7
]RESCOTT 26-5!'t8.5(t7 t.tE tei 132 7A tm
ROSLYN 2t.00 14.0(19{'l-o12 1.20t t37 54 3i 06
JNIONTOWN 2s_o0 15_0t 217 3{ll 5?,tlaoi rd fro
.EC,N ao 6I 25.7t ?5 ?a 5.0(onn
.ENORE ao at 25.7i 23 ,A1 7et l7A)t 19lX
lrobt€l rlrel*r
louts Mlleege
l,utslde Exchsnge
s.6t s.Bt
folal 49:t 2.0osl 2..lsE 850.18 110.71
Na Erdrrnd*6l
USDA.EUS
OPERATING REPORT FOR
TELECOMMUNICATIONS BORROWERS
/rvSTRarCIrOrVS - S ee RUS Buldin ;71+2
BORROWER DESIGNATION
w40534
PERIOD ENDEO
Decqnber,2013
Part C. SIJBSCRISER (ACCESS LlNEl. ROUTE MILE- & HIGII SPEED IIATA !NI'oRMATIoN
Detallr on Leerl Eroandm Bmadhlnd Sarulce
EXCHANGE No- Accasc Llnss
slrh B8
av8IaHo
No OtBmadband
Subsalbors
tbl
Number OfSubsslbrs Advertbed
Downbed Ral€(KbF)
Ady€trdsod
UdoadRats,(KbpB)
Pdc€ Per Monlh SbndalonalPclg
,n
Type ol
Tecturology
)EWATTO 3tt ,)T T1 I OnO r Sfin 45.9!:tst
)RESCOTT 16i aa AE r88 i12 !t5.95lPa.rooe ,3L
RCISLYN I 2'le Aa!7Lt l.m0 t.500 35.9!lid(ro€)SL
UNIOTTOWN 821 18:,.000 t.500 35.9!PeckEao lsL
LEON )F t.m0 t.500 35.S!Prcl€86 lsL
I FNORE 268 13t t3t t68 i12 3s.0!PeclGda lsL
fdel 2.45I.1.49!
USDA.fIUS
OPERATING REPORT FOR
TELECOMMUNTCAT]ONS BORROV{ERS
tsottttgwER uEslgNA r ruN
l{Aos34
PEHIUIJ ENUINLi
December, 2013
IVSTRUCnO/VS- See RUS Edk/ttn I 7U-2
pi*r o. ,r=reu oara
,No.PlotEnpbyq llNo.OftqEndorsral {o l- Sqre Hils Socd
453
,l.AG6UEpcrSqucMllc
5 .40
5. SDbElbar F R@lc Uilc
2.94
PARTE TOLLDATA
Shrdy Arsa lD Cod6(s)
r.472423
b.5L
a-
d.
c.
t
0._
h-(_
t.
2. Types ofTol Soulomants (Cl|ect( ons)
lnlordsie:I Arlerage Schodulc
I Avcnga Sctradulalntrastato:
[l co*aa"i"
p c*a..,,
PART F. FUNDS INVESTED IN PI.AI{T DURINO YEAR
l- RUS. RTB. & FFB Lm Fundg Exoendad L,653,225
Olher Lono-Tem Loan Funda Eroerded
l. Furds Er!€rdsd Under RUS lnlsrlm Amrot,al
l. OlhEShort-Tm Lmn Funde Ererded
GerEral Funds B(g8ndsd (Othsr lhan lntodm)
I Salnoed Matarlals 3,000
Conhibufion ln Ald lo Consbucdm
!. Gross Addlilons lo lelmm. Plant l'l thru 7)1. 656 .22S
PART G. IttlVESTttEt{fS lN AFFILIATED COMPAI{IES
INVESTMENnl
CURRETIT YEAR OAT CUIIIUIAIIVE DATA
ItrEhtlnt
Ttds Yau
ht
lncomdl.o3!
Ihlr Yost
CmulrilE
llrutmlnt
To 08lr
d)
CmdsllE
lffidLu
To Dsts
Cmlnl
BalenB
lnvosbncnl ln Affilldlad Com6snl6r - Rural Oavaloomanl 51,709 51, 709 51, 709
lnvEstrnsnl ln Aflillatad ComDanle6 - l,lonrural Dsr,elopmsnl
Psge 5 of 6
USDA.RUS
OPER.ATING REPORT FOR
TELECOMM UNICATIONS BORROVUERS
BORROWER DESIGNATION
}I40534
'ERIOD ENDING
)eceniber, 2013
PART H. CURRENT DEPRECI,ATION RATES
Arc corporation's &prtciation ratcs approvcd by the rcgulatory authority
withjurisdiction ovcr ihc pmvision oftelcphonc ccrrriccs? (Chcck onc)EI YES trI NO
EOUIPMENT CATEGORY DEPRECIATION RATE
Land and suoDort assBts - Motor Vehlcles 16.00t
Land and suDDort assels - Alrcreft
l. Land and support Essets - SDecial purpose vehlcles
l. Land and suDoort assets - Garage and olhorwork equipment 16. 00i
i. Land and support assets - Buildings 1r .001
]. Land and support assets - Fumihrre and Office equlpment 15.00t
Land and suDDort assets - General DurDosB comDuters 25.00t
l. CenEal Omce Swltchlns - Dioital 9.00t
). Conlral Office Swltchino - Analoo & Electro+nechanlcal
0. Cenhal Office Swltchlnq - Ooerator Systems
1. Central Office Transmlssion - Radio Svslems 13.00t
12. Central Office Transmisslon - Clrcuit eouiomenl L1.19t
1 3. lnformation onloination/terminatlon - Station aooaratus
14. lnformallon orloination/termlnatlon - Customer oremlses wlrlno
15. lnformation orlsinatory'termination - Lame orivate branch exchanqes
16. lnformallon orloination/termlnatlon - Public teleohone termlnal eouioment
17. lnformation oriolnatlon/termlnation - Other termlnal eouioment
18. Cable and wire faclllties - Poles 7. S9t
19. Cable and wire facilltles - Aerlal cable - Metal 42.06t
20. Cable and wire faciliUes - Aerial cable - Fiber 5.00t
11. Cable and wire facilities - Underoround cable - Metal 6 .00t
12. Csble and u,lre facllities - Underoround cable - Flber 5.00t
23. Cable and wire facilities - Burled cable - Metal
14. Cable and wire facillties - Buried cable - Flber
!5. Cable and wlre facllities - Conduit svst€ms
16. Cable and wira facillties - Olher
Page 0 of 6
USDA.FUS
OPERATING REPORT FOR
TELECOMM UNIGATIONS BORROWERS
BORROWER DESIGNATION
t{Ao53,1
PERIOD ENDED
Dcccmber, 2013
INSTRUCTIONS - See help ln the onllne appllcatlon.
PART I . STAIEMENT OF CASH FLOWS
1.Beglnnlng Cash (Cash and Equlvalents plus RUS Gonslruction Fund)5?4.797
CASH FLOWS FROM OPERANNG ACTIVITIES
2. Net lncome { 302, {03 )
Adiuslmenls to Reconclle Nel lncome lo Nel Cash Provldad by Opamttng Aclivlllas
3.Add: Deoradatlon 1. 316 . 875
4. Add: Amorthation 182
5.Other (Explaln)
sce spreadabect ln notes aecElon (1,0{9,066}
Chanoes ln ODerallno Assols and Uabllllles
.6.. Decrease/(lncreass)lnAccountsRecelvable (185,120)
7.Decrease/{lncrease) in Materlals and lnventory (9,911)
8.Decrease/(lncrease) ln Preoavments and Delened Charg€s (35,?1S)
9.D6craase/(lncrease) ln Other Cunent Assets 0
10.lncrease/(Decrease) ln Accounts Payable 942 .087
11 lncrease/(Decrease) in Advance Billinos & Pavmenls
12.lncrease/(Decrease) ln Other Cunent Llablllties 163, 174
13.Net Cash Provlded/lUsed) bv Ooeratlons 8{0, 103
CASH FLOWS FROM FINANGING ACTIVITIES
14.Decrease/(lncrease) in Notes Receivable 0
t5.lncrease/(Decrease) ln Notes Pamble 0
16.lncreasel(Decreass) ln Customer Deposits 449
17.Net lncrease/(Decrease) ln Long Term Debt (lncluding Cunent Maturitles)1,73t .281
18.lnoeasey'lDecreasel ln Other Liabilities & Defened Credits ( 188, {861
19. lncrease/(Deca€ase) ln Caoltal Stock, Pald-ln Capi&al. Membershlp and Capital Certil'icates & Other Capilal o
20.Less: Payment of Dlvldends 0
21.LBss: Palronaoe Caoital Cradils Retired 0
22.Other (Explaln)
see epreadaheet ln noEeE aection
1S8, 037
23.Net Cash Provldsd/{Used) by Flnanclng Actlvltles L,1tt,28t
CASH FLOWS FROM INVESTING ACNVMES
24.Nst Caoilal ExDenditurss (Prooertv. Plant & Eouloment)(2,519,330)
25.Olher Lonq-Term lnvestrnents 1752,7431
28.Other Noncunent Assets & Judsdicllonal Dlfferances 0
27.Other (Explain)
sce rpraadsheet Ln noEes EecELoD 830, lzl
28, Nat Cash Provldadt(usidl bv lnvestino Actlvltles (2, {51,952)
29.Net lncrease/(Decreasel ln Cash 119, 432
30. Endinq Cash 694,229
Revlsion Date 2010
\TES
lelo,
PART I
CASH
Llno 5
Cash
Less
BORROWER DESIGNATION
wAo534
E3,144
tt49
(6,708)
INSTRUCTIONS - Scc RUS tsullctir 17,14-2 PERTOD ENDED
Decsmber,20!3
NOTES TO THE OPERATING REPORT F'OR TET.ECOMMT'NICATTONS BORROWERS
RATES ARE ON PAGE 6)
lnt 12.50%, Other Worlt Equipment-|250%, Bulldings-2.50%, Fumhure-15.00%, Company Communlcations
!-ZS.O0%, Office Support Equlpment-5.00%, COE Swltchlng-9.00%, COE Transmlsslon-ii.19%, COE Radlo-
ed Cable"{.00%, Fiber Optic.4.00%, Aerial Wire-8.00%, Aerial Flber-{.00%
STATEMENT OF CASH FLOWS
.OW RECONCIUNG EXPISNATIONS
Ion
ther
rtlon and amorllzatlon on nonrcgulaled lnvestments
ln deposhs
rrender yalue of llfu lneurance
nt ln.AP
Amount
Total
LIns
Total
Llne 27
Total
USDA.RUS
OPERATING REPORT FORTTI .R'.IMMI INII-ATI.INS Nr}RP()UT'ERS
BORROWER DESIGNATION
wAo534
l7'l
(44e)
3,000
121
NSTRUCTIONS - Scc RUS Bullain l7{4-2 ]ERIOD ENDED
Dcccrnbcr,2013
NOTES TO TIIE OPERATING REPORT FOR TELECOMMUNTCATIONS BORROWERS
I and stato lncom€ tax€s
h stock dlvldend
rount of Adrustment
(1
Cthor
ify change ln defurrad crodlts to oporatlng activities
fy deposlt change to operatng actlvltios
rount ofAdrustnent
)ther
al amounts of capltal expEnditures
al amounts of long.term lnvostmentE
tount of Adiustment
BORROWERDESIGNATION
wA0534
INSTRUCTIONS . Scc RUS Bullctin 1744-2 PEBJOD ENDED
Dccember,2013
CERflNCATION LOAN DEF'AULT NOTES TO THE OPERATING NEFORT T'OR TELECOMMI,'NICATIONS BONROWERS
State of Washington
County of Kittitas
) CERTTFTCATTON BY ELtGtBLE TELECOMMUNTCATIONS CARRTER
) ss OF COMPLIANCE WITH SERVICE QUALITY AND CUSTOMER
) PROTECTION, AB|LTTY TO REMATN FUNCTTONAL tN
EMERGENCIES, AND USE OF FEDERAL HIGH-COST SUPPORT.
AFFIDAVIT OF BUSINESS OR GORPORATE OFFICER
The ldaho Public Utilities Commission Order No. 29841requires that Eligible Telecommunications
Carriers certify that it is compliant with applicable service quality standards and consumer protection
rules; and ETCs must demonstrate the abili$ to remain functional in emergencies. ln addition, the
Commission must file an annual certification with the USAC and the FCC that all federal high-cost support
provided to ETCs within the State of ldaho will be used only for the provision, maintenance, and
upgrading of facilities and services for which the support is intended. Accordingly, the undersigned states
and verifies under oath the'following:
1. I am an officer of lnland Telephone Company, an eligible telecommunications carrier for receiving
federal universal service support under section 214lel of the Telecommunications Act of 1996 in the state
of ldaho.
2. 1 am familiar with the Company's day-to-day operations in the state of ldaho and with the State's
service quality standards and consumer protection rules as set forth in Commission Order No. 29841.
3. lnland Telephone Company is complying with applicable service quality standards and consumer
protection rules of the Federal Communications Commission and the ldaho Public Utilitles Commission.
4. I certify to the Commission that the Company is able to remain functional in emergencies as set forth in
Commission Order No.29841 and in 47 C.F.R. $ 54.201(a)(2).
5. I also certify that all federal universal service support funds received by lnland Telephone Company
during the current calendar year will be used in a manner consistent with section 254(e); that is, for the
provision, maintenance, and upgrading of facilities and services for which the support is intended. The
company will continue to comply for the period of January 1,2015, through December 31, 20't5, to be
eligible for federal universal service fund support-
6. This verification and afiidavit is provided to be the ldaho Public Utilities Commission to enable the
IPUC to certify to the FCC that federal universal service support received by the eligible cariers in the
state will be used in a manner consistent with Section 254(el of the Telecommunications Act.
Date: June 30.2014
SUBSCRIBED AND SWORN to before me this
PAMELA R. NELSON.
'{OTARY
PUBLIC
STATE OF WASHINGTO'I
COi/6,llSSlON EXPIRES
T;'*'m"iro('.:P? ll,X
*" t"" " *'sh in ston'
EF 9.2015
My Commission expires S- *. 4 ,-rt*. tS
FCC FORM 487 uN)
INIIND TELEPHONE COMPANY
IDAHO OPERATIONS . 472423
FIVE YEAR FORECAST. NETWORK ADDITIONS
As they are known to the Company at the date of this Report, the planned investments and forecasted
expenses related to Idaho operations (Study Area Code 472423l,for the period January l,2Ol4 through
December 31, 2OlB, are listed below. The Company expects to use all Universal Service Fund support
received in order to fund the expenses related to the provisioning, maintenance and services provided over
these upgraded facilities as well as existing facilities and to service the debt with the Rural Utility Service
created in order to make these improvements; improving service quality, coverage and capacity. The
Company (S,AC 472423) received $405,725 in federal high-cost support for the calender year ended
December 3 1 , 20 13. The Company expects that the continued receipt of Universal Service Fund support
will aid the Company's efforts to continue to provide the supported services at rates that are comparable to
the rates for such services in urban areas of which all customers and potential customers in the Company's
designated ETC service area will benefit.
2014 2015 20t6 20t7 2018
LENORE 1836)
Access Lines (@ 1213U20731 268
Data Subscribers (@ 72l3U2ot3l 138
I M icrowave (nlt/rthernet)4s0,000
Fiber to the Node 1,000,000
Electronics s00,000
TOTAL LENORE 1,950,000
LEON (2241
Access Lines (@ 7213712073l,26
Data Subscribers (@ 72137120731 15
Fiber to the Node 100,000
Electronics 30,000
TOTAL LEON 130,000
TOTAT 130,000 1,950,000 0 0 0
FORECASTED OPERATING EXPENSES
PLANT SPECI FIC OPERATIONS 420,743 444,782 472,973 505,051 541,398
PLANT NON-SPECI FIC OPERATIONS 43,182 47,076 39,t72 37,287 35,574
ACCUM ULATED DEPRECIATION 193,009 251,509 305,509 306,509 306,509
CUSTOM ER OPERATI ONS EXPENSES 67,405 69,L37 70,914 72,737 74,609
CORPORATE OPERATIONS EXPENSES 136,698 729,433 122,643 776,296 110,354
TOTAL OPERAT!NG EXPENSES 860,438 93s,937 1,072,150 7,037,874 1,068,453
Filename: 140630 ITC FORECAST.xIsx FIVE YEAR-472423
FCC Form 555
December 2013
Approved by OMB
3060-08 l9
Annual Lifeline Eligible Telecommunications Carrier Certilication Form
AII cariers 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 3ln (Annually)
ldaho
State
(An Eligible Telecomnrunications Canier (ETC) nrust provide a certiJicationform for each slate in vhich it provides Lifeline .ret'ur'ce),
472423 lnland Telephone Company
Study Area Code(s) (SAC)ETC Name(s)
Westem Elite lncorporated Services lnland Networks
Holding Company Name(s)DBA, Marketing or Other Branding Name(s)
Affiliated ETCs (include nsrnes and SACs, attach See list of Affiliated ETC'saddilional sheets i
Provide a list of all ETCs that are atliliated with rhe reportitrg ETC. )fiilialion shall be delerminetl in accordance vith seclion 3(2) of the
Communicaliotrs Act. Tlnt Section delines "afiiliate" as "a person lhal (directly or indirectly) owns or controls, is o\t,ned or controlled by, or
is under comnon owncrship or control tvith, onother person." 17 U,S.C. I I 5i@. See also 17 C.F.R. S 76.12A0.
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 rvould typically be president, vice president for operations, vice president for
finance, comptroller, h€asurer, or a comparable position. If the filer is a sole proprietorship, the owner must sigl the
certification
Section l: All ETCs MAST COMPLETE SECTION 1- Initiol Certitication
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 crylpany named above. I am authorized to make this certification for the Study Area(s)
listed above. lnitial dp'II
Approved by OMB
3060-0819FCC Form 555
Dcember 2013
Section 2: All ETCs MUST COMPLETE SECTION 2-Annual RecertiJication
Do not leave enrpty colwnns. If an ETC hos nothing lo reporl in a column, enter a zero,
A B C
Numbcr of
Subscribers Chlmrd on
Ftbruary FCC Form(s),197
ofsurrcnt Form 555
colendar ycnr
Number of Lincr Chlmcd on
Frbrurry FCC Form(r) 497
ofrurrcut Forn555
cakndrr ycrr provldcd lo
lYlrclinc Reccllcrs
Numbtr of Subccribcn clnimcd
on lbc Februrry FCC Form(!)
{97 thrt werc iniliolly cnrollcd ir
currcot Form 555 crlcndnrycar
6 0 0
Initiql lhe ceilirtcations below that apply to your ETC and complete the lables corresponding to the certiJicalion belatv. Depending
on Ihe eIale, BOTH CERTIFICATION A AND B fuUYAPPLY.
A) I certiff that the company listed above has procedures in place to recertifr 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
D E F=D-E c 6 = (F+G)I
Numher of
Subseribcrs ETC
Contactcd Dircctly
to Recefii$
Eligibility Through
Attcstation
Number of
Subscribers
Rcsponding to
ETC Contact
Number ofNon-
Responding
Subscribcrs
Number of
Subscribcrs
Rcrponding That
Thcy Arc No
Longer Eligihle
Numbcr ofSubscribers
Dc-enrolled or
Schcdulcd to bc De
Enrollcd as a Rcsult of
Non-Rcsponsc or
lnclisibilitv
Numbcr of
Subscribers Who
De-Enrolled Prior
to Rcccrtlfication
Attempt
AND/OR
In lhe space 6sl61v, please list lhe progranr eligibility dala sources, such as ETC access to a stale database and/or nolice of
eligibitityfronr lhe state Lifeline adntinistrator or the Universal Service Adminislrative Contpany (USAC), and indicale for vhich
qualifying programs (e.g., SNAP, SSI) lhese sources at'e used to verifu subscriber eligibility. If any of subscribers are
subsequently contacted directly by the ETC in an allempt to recertify eligibility, those subscribers should be listed in colunns D
through I as appropriate and not in columns J lhrough L.
B) I certifr that the company listed above has procedures in place to re-certify consumer eligibility by relying on
Community Action Partnership Association (CAPA) of ldaho . Results are
provided in the chart below. I am an offrcer of the above. I am authorized to make this
certification for the Study Area(s) listed above. Initial
OR
C) I certift that my company did not clairn federal low income support for any Lifeline subscribers for the February
Form 497 data month for the curent Fonn 555 calendar year. I am an officer ofthe company named above. I am
authorized to make this certification for the Study Area(s) listed above. Initial _
Number of
Subscribers De-Errollcd or
Schedulcd to be Da'Enrollcd as a
Rcsult of Fiuding of Incligibility by
Strtc Administralor, ETC Access to
Eligibility Dato or USAC
Number of Subscribcrs Who
Ds.Enrollcd Prior lo
Rcccrtilicntion Attcmpl
Number ofSubscriberg
lVhose Eligibility was
Revicrved By Statc
Admiuistrator
ETC Access to Eligibility
Data or bv USAC
Approved by OMB
3060-08 I 9FCC Form 555
December 2013
Section 3: ALL ETCS MUST COMPLETE SECTION 3 - De-enroll percentage
lllhat is the percentage of sabscrlbers de-enrolledfor this ETC?
SeCtion 4: ALL ETCS MUST COMPLETE APPROPRIATE CHECK BOX; PRE-PAID ETCS MUST
COMPLETE ALL OF SECTION 4
Is the ETC Pre-Paid?
fes [ *" V Ql Pre-Paid ETC does not assess or collect a monthtyfeefrom its Lifeline subscribers)
If yes, record the number of subscribers de-enrolledfor non-usage bymonlh in colurnn S below.
Non-Usage Resalts Appllcable to Pre-Poitl ETCs:
R s
Month Subscribers De.Enrolled for Non-Usase
January
Februarv
March
April
May
June
July
Ausust
September
October
November
December
Signature Block: ALL ETCS MUST COMPLETE SIGNATURE FIELDS
By signing below, I certify that the company listed above is in compliance with all federal Lifeline certification
procedures. I arn an officer of the company named above. I am authorized to make this certification for the Study
Area(s) listed above.
NI N o P= N+O O=ttP+llllil00!
Number of
Subscrlbrrs Chlmed
on Fcbrurry FCC
Form(s! 497
(From Colunn A)
Numbcr ofSubrtribcrs
De Enrolhd or
Schedutcd to bc Dc-
Enrolhd ar r Rcsult of
NorRcspomc or
Imllglblllty
(From Colwnn H)
Numbcr ofSubrcrlbcrr
Dc- Enrollcd or
Sctcdulcd lo bc Dc-
Enrollcd rs e Rcsuli of
r Findlng of Incligibility
(FromColunm K)
Tolal Numbcr of
Subscriberr Dc-Enrollcd
or Schcdulcd to bc Dc-E
nrollcd
Perccnlngc of Subscrlbcrs
Dc-Enrollcd or Scbcduled l(
bc Dc-Enrollcd lbrt vcrc
Chlmcd on lhr
Fcbrunry FCC Form(r) tl97
5 2 2 40
Approved by OMB
3060-08 I 9FCC Form 555
December 2013
James K. Brooks
Printed Name of Officer
01t30t2014
Date
[phone]
Person Completing this Certification Form Contact Phone Number
ETC Identification
SAC F-TC Name
472423 lnland Teleohone ComDanv
522423 lnland Telephone Company
479007 lnland Cellular LLC (f/Ua Washington RSA No. I L.P.)
529003 lnland Gellular LLC (f/Ua Washlngton ESA No. E LP.)
529004 lnland Cellular LLC (flUa Eastem Sub-RSA LP.)
Holdins Com ,aalt N s
SAC Holdine Comoanv Name
47242X W€st€m Ellt€ lncorporaled SeNlce6
522423 Westem Ellte lncorporated SeMces
479007 lnland C.llular TalBphono Company
529003 lnland Cgllular Telephone Company
529004 lnland Cellular Telephono Company
DBA, Mar or Other B Name s
SAC Name
472423 lnland Netwcrks
522423 lnland Networks
479007 lnland Cellutar
s2s003 lnland Cellutar
529004 lnlard Cellular
Approved by OMB
3060-08r 9
Affiliated ETCs
SAC Name
522473 lnland Telephone Company (d/b/a lnland Networks)
479007 lnland Collular LLC (flUa Washinslon RSA No. I L.P.Xrr/b/a lnlend Cellular)
52S003 lnland Callular LLC (frua Washlngton RSA No. I L.P.)(d/b/a lnland Cellular)
529004 lnland Collular LLC (t/Ua Eastem Sub-RSA L.P.)(d/b/a lnland C€llular)
AIINUAL SECTION 6a.2009(e) CERTIFICATION
EB Docket No. 06-36
Annual $ 6a.2009(e) CPIIII Certification for 2013
Dated: February l2r2014
Company: Inland Telephone Company
Form 499 Filer ID Numberz 802299
Name of Signatory: James I( Brooks
Title of Signatory: Treasurer/Controller
I, James K. Brooks, certify that I am a duly authorized officer of Inland Telephone
Company ("lnland" hereafter) and, acting as an agent of Inland, that I have personal knowledge
that krland has established operating procedures that are adequate to ensure compliance with the
Customer Proprietary Network Information ("CPNI") rules of the Federal Communications
Commission ("Commission"), codified at 47 C.F.R. Part 64 Subpart U, implementing Section
222 of the Communications Act of 1934, as amended.
Accompanying this certification is a statement explaining how lnland's procedures
ensure that the company is in compliance with the requirements set forth in section 64.2001 et
seq. of the Commission's rules.
Inland has not taken any actions (proceedings instituted or petitions filed by Inland at
either state cornmissions, the court system, or at the Commission against data brokers) against
data brokers in the past year. During the calendar year ended December 3l,zDl3,Inland did not
acquire first-hand any information that it has identified as being information with respect to the
processes pretexters are using to attempt to access CPNI.
Inland has not received any customer complaints in the past year concerning the
unauthorized release of CPM.
K. Brooks
TRIBAL ENGAGEMENT STATEMENT
Although the service area of the Lenore exchange of Inland Telephone
Company, Idaho operations, is within the conventional boundaries of the Nez
Perce Tribe reservation, the exchange primarily consists of private property
(non-tribal). Inland does not serve the areas in which the Nez Perce have their
tribal headquarters, administration, enterprises, cultural center and anchor
institutions. Inland Telephone Company is an equal opportunity provider and
does not ask or keep track of race, creed, color or sexual orientation when
providing service; we wouldn't know if a subscriber was a tribal member unless
they were claiming Tribal Lifeline.