20140702Q-Link Wireless FCC Form 481.pdf

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FCC Form 481FCC Form 481 - Carrier Annual Reporting OMB Control No. 3060-0986/OMB Control No. 3060-0819
July 2013
<010>Study Area Code <015>Study Area Name <020>Program Year <030>Contact Name: Person USAC should contact with questions about this data
<035>Contact Telephone Number: Number of the person identified in data line <030> <039>Contact Email Address: Email of the person identified in data line <030>
54.313
Completion
Required
54.422
Completion
Required
<100>Service Quality Improvement Reporting
<200>Outage Reporting (voice)
<210><-- check box if no outages to report

<300>Unfulfilled Service Requests (voice)
<310>Detail on Attempts (voice)
<320>Unfulfilled Service Requests (broadband)
<330>Detail on Attempts (broadband)
<400>Number of Complaints per 1,000 customers (voice)
<410>Fixed
<420>Mobile
<430>Number of Complaints per 1,000 customers (broadband)
<440>Fixed
<450>Mobile
<500>Service Quality Standards & Consumer Protection Rules Compliance
<510>
<600>Functionality in Emergency Situations
<610>

<700>Company Price Offerings (voice)
<710>Company Price Offerings (broadband)
<800>Operating Companies and Affiliates
<900>Tribal Land Offerings (Y/N)?
<1000>Voice Services Rate Comparability
<1010>
<1100>Terrestrial Backhaul (Y/N)?
<1110>
<1200>Terms and Condition for Lifeline Customers
Price Cap Carriers, Proceed to Price Cap Additional Documentation Worksheet
Including Rate-of-Return Carriers affiliated with Price Cap Local Exchange Carriers
<2000>
<2005>
Rate of Return Carriers, Proceed to ROR Additional Documentation Worksheet
<3000>
<3005>
ANNUAL REPORTING FOR ALL CARRIERS
(if yes, complete attached worksheet)
(check to indicate certification)
(if not, check to indicate certification)
(complete attached worksheet)
(attached descriptive document)
(check to indicate certification)
(complete attached worksheet)
(complete attached worksheet)
(complete attached worksheet)
(check to indicate certification)
(attached descriptive document)
(attach descriptive document)
(complete attached worksheet)

(complete attached worksheet)
(complete attached worksheet)
(attach descriptive document)

(complete attached worksheet)
(check to indicate certification)
(complete attached worksheet)
(check to indicate certification)

(attach descriptive document)

(check box when complete)

Data Collection Form

4
Heather Kirby
2015
0.0
[e-mail]
4
4
4
Q Link Wireless LLC
4
7702327805 ext.
0.0
4
4
479018
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<010>
<015>
<020>
<030>
<035>
<039>
<110>Has your company received its ETC certification from the FCC?(yes / no )
<111>
If your answer to Line <110> is yes, do you have an existing §54.202(a) "5
year plan" filed with the FCC?(yes / no )
If your answer to Line <111> is yes, then you are required to file a progress
report, on line <112> delineating the status of your company's existing §
54.202(a) "5 year plan" on file with the FCC, as it relates to your provision of
voice telephony service.
<112>Attach Five-Year Service Quality Improvement Plan or, in subsequent years,
your annual progress report filed pursuant to 47 C.F.R. § 54.313(a)(1). If your company is a
CETC which only receives frozen support, your progress report is only
required to address voice telephony service.
112, contains a progress report on its five-year service quality improvement
plan pursuant to § 54.202(a). The information shall be submitted at the wire
center level or census block as appropriate.
<113>Maps detailing progress towards meeting plan targets
<114>Report how much universal service (USF) support was received
<115>How (USF) was used to improve service quality
<116>How (USF)was used to improve service coverage
<117>How (USF) was used to improve service capacity
<118>Provide an explanation of network improvement targets not met in the prior calendar year.

Study Area Code
Study Area Name
Program Year
Contact Name - Person USAC should contact regarding this data
Contact Telephone Number - Number of person identified in data line <030>
Contact Email Address - Email Address of person identified in data line <030>
(100) Service Quality Improvement Reporting FCC Form 481
Data Collection Form OMB Control No. 3060-0986/OMB Control No. 3060-0819
July 2013

Heather Kirby
2015
[e-mail]
Q Link Wireless LLC
7702327805 ext.
479018
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(200) Service Outage Reporting (Voice)FCC Form 481
Data Collection Form OMB Control No. 3060-0986/OMB Control No. 3060-0819
July 2013
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<220><a><b1><b2><b3><b4><c1><c2><d><e><f><g><h>
NORS
Reference
Number
Outage Start
Date
Outage Start
Time
Outage End
Date
Outage End
Time
Number of
Customers Affected Total Number of
Customers
911 Facilities
Affected
(Yes / No)
Service Outage
Description (Check
all that apply)
Did This Outage
Affect Multiple
Study Areas
(Yes / No)
Service Outage
Resolution
Preventative
Procedures

Heather Kirby
2015
[e-mail]
Q Link Wireless LLC
7702327805 ext.
479018
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(700) Price Offerings including Voice Rate Data FCC Form 481
Data Collection Form OMB Control No. 3060-0986/OMB Control No. 3060-0819
July 2013
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<701>Residential Local Service Charge Effective Date
<702>Single State-wide Residential Local Service Charge

<703><a1><a2><a3><b1><b2>
State Exchange (ILEC)SAC (CETC)Rate Type
Residential Local
Service Rate

<c>
Total per line Rates and Fees
<b5>
Mandatory Extended Area
Service Charge
<b4>
State Universal Service Fee
<b3>
State Subscriber Line Charge

Heather Kirby
1/1/2014
2015
[e-mail]
Q Link Wireless LLC
7702327805 ext.
479018
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(710) Broadband Price Offerings FCC Form 481
Data Collection Form OMB Control No. 3060-0986
July 2013
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>

<711><a2><b1><b2><c><d1><d2><d3><d4>
Exchange (ILEC)Residential Rate
State Regulated
Fees Total Rate and Fees
Broadband Service -
Download Speed
(Mbps)
Broadband Service -
Upload Speed (Mbps)
Usage Allowance
Action Taken When
Limit Reached {select}

<a1>
Usage Allowance
(GB)

State
/OMB Control No. 3060-0819

Heather Kirby
2015
[e-mail]
Q Link Wireless LLC
7702327805 ext.
479018
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(800) Operating Companies FCC Form 481
Data Collection Form OMB Control No. 3060-0986
July 2013
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<810>Reporting Carrier
<811>Holding Company
<812>Operating Company

<813>

<a3>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
<813>

<a3>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
<813>

<a3>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
<813>

<a3>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
/OMB Control No. 3060-0819

Heather Kirby
N/A
2015
[e-mail]
Q LINK WIRELESS LLC
Q Link Wireless LLC
7702327805 ext.
-- See attached worksheet --
QUADRANT HOLDINGS GROUP LLC
479018
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(900) Tribal Lands Reporting FCC Form 481
Data Collection Form OMB Control No. 3060-0986
July 2013
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<910>Tribal Land(s) on which ETC Serves

<920>Tribal Government Engagement Obligation
Select
(Yes,No,
NA)
<921>
<922>Feasibility and sustainability planning;
<923> Marketing services in a culturally sensitive manner;
<924>Compliance with Rights of way processes
<925>Compliance with Land Use permitting requirements
<926>Compliance with Facilities Siting rules
<927>Compliance with Environmental Review processes
<928>Compliance with Cultural Preservation review processes
<929>Compliance with Tribal Business and Licensing requirements.

/OMB Control No. 3060-0819

Heather Kirby
2015
[e-mail]
Q Link Wireless LLC
7702327805 ext.
479018
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(1100) No Terrestrial Backhaul Reporting FCC Form 481
Data Collection Form OMB Control No. 3060-0986/OMB Control No. 3060-0819
July 2013

<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
Please check this box to confirm no terrestrial backhaul
options exist within the supported area pursuant to § 54.313(G)
Please check this box to confirm the reporting carrier offers
broadband service of at least 1 Mbps downstream and 256 kbps
upstream within the supported area pursuant to § 54.313(G)
<1120>
<1130>

Heather Kirby
2015
[e-mail]
Q Link Wireless LLC
7702327805 ext.
479018
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(1200) Terms and Condition for Lifeline Customers FCC Form 481LifelineOMB Control No. 3060-0986/OMB Control No. 3060-0819Data Collection Form July 2013

<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<1210>Terms & Conditions of Voice Telephony Lifeline Plans
<1221>
<1222>
<1223>Additional charges for toll calls, and rates for each such plan.
<1220>Link to Public Website HTTP
Information describing the terms and conditions of any voice telephony service plans offered to Lifeline subscribers,
Details on the number of minutes provided as part of the plan,

Heather Kirby
2015
[e-mail]
479018 ID 1210.docx
Q Link Wireless LLC
7702327805 ext.
4
4
4
479018
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(2000) Price Cap Carrier Additional Documentation FCC Form 481
Data Collection Form OMB Control No. 3060-0986/OMB Control No. 3060-0819
Including Rate-of-Return Carriers affiliated with Price Cap Local Exchange Carriers July 2013

<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
Incremental Connect America Phase I reporting
<2010>2nd Year Certification {47 CFR § 54.313(b)(1)}
<2011>3rd Year Certification {47 CFR § 54.313(b)(2)}
Price Cap Carrier Receiving Frozen Support Certification {47 CFR § 54.312(a)}
<2012>2013 Frozen Support Certification
<2013>2014 Frozen Support Certification
<2014>2015 Frozen Support Certification
<2015>2016 and future Frozen Support Certification
Price Cap Carrier Connect America ICC Support {47 CFR § 54.313(d)}
<2016>Certification Support Used to Build Broadband

Connect America Phase II Reporting {47 CFR § 54.313(e)}<2017>3rd year Broadband Service Certification
<2018>5th year Broadband Service Certification<2019>Interim Progress Certification
<2021>Interim Progress Community Anchor Institutions
Name of Attached Document Listing Required Information

<2020>
CHECK the boxes below to note compliance as a recipient of Incremental Connect America Phase I support, frozen High Cost support, High Cost support to offset access charge reductions, and Connect America Phase II
support as set forth in 47 CFR § 54.313(b),(c),(d),(e) the information reported on this form and in the documents attached below is accurate.

Heather Kirby
2015
[e-mail]
Q Link Wireless LLC
7702327805 ext.
479018
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(3000) Rate Of Return Carrier Additional Documentation FCC Form 481
Data Collection Form OMB Control No. 3060-0986/OMB Control No. 3060-0819
July 2013

<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>

Progress Report on 5 Year Plan(3010)Milestone Certification {47 CFR § 54.313(f)(1)(i)}
Name of Attached Document Listing Required Information
(3012)Community Anchor Institutions {47 CFR § 54.313(f)(1)(ii)}
Name of Attached Document Listing Required Information
(3013)Is your company a Privately Held ROR Carrier {47 CFR § 54.313(f)(2)}(Yes/No)
(3014)If yes, does your company file the RUS annual report (Yes/No)
(3017)If the response is yes on line 3014, attach your company's RUS annual
report and all required documentation
Name of Attached Document Listing Required Information
(3018)If the response is no on line 3014, Is your company audited?(Yes/No)
If the response is yes on line 3018, please check the boxes below to

confirm your submission, on line 3026 pursuant to § 54.313(f)(2), contains
:
If the response is no on line 3018, please check the boxes belowto confirm your submission, on line 3026 pursuant to § 54.313(f)(2),
contains:
(3024)Underlying information subjected to an officer certification.
(3026)Attach the worksheet listing required information
Name of Attached Document Listing Required Information
(3022)
(3023)
(3025)
(3015)
(3016)
(3019)
(3020)
(3021)
Copy of their financial statement which has been subject to review by an independent certified public accountant; or 2) a financial report in a
format comparable to RUS Operating Report for Telecommunications
Borrowers,
Underlying information subjected to a review by an independent certified
public accountant
Electronic copy of their annual RUS reports (Operating Report for
Telecommunications Borrowers)
Either a copy of their audited financial statement; or (2) a financial report in a format comparable to RUS Operating Report for Telecommunications
Management letter issued by the independent certified public accountant that performed the company’s financial audit.

(3011)
CHECK the boxes below to note compliance on its five year service quality plan (pursuant to 47 CFR § 54.202(a)) and, for privately held carriers, ensuring compliance with the financial reporting requirements set forth in 47
CFR § 54.313(f)(2). I further certify that the information reported on this form and in the documents attached below is accurate.

Heather Kirby
2015
[e-mail]
Q Link Wireless LLC
7702327805 ext.
479018
Page 12
Page 12
Certification - Reporting Carrier FCC Form 481
Data Collection Form OMB Control No. 3060-0986/OMB Control No. 3060-0819
July 2013
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
TO BE COMPLETED BY THE REPORTING CARRIER, IF THE REPORTING CARRIER IS FILING ANNUAL REPORTING ON ITS OWN BEHALF:
Printed name of Authorized Officer:
Certification of Officer as to the Accuracy of the Data Reported for the Annual Reporting for CAF or LI Recipients
Name of Reporting Carrier:
Signature of Authorized Officer:Date
I certify that I am an officer of the reporting carrier; my responsibilities include ensuring the accuracy of the annual reporting requirements for universal service support
recipients; and, to the best of my knowledge, the information reported on this form and in any attachments is accurate.
Title or position of Authorized Officer:
Telephone number of Authorized Officer:
Study Area Code of Reporting Carrier:Filing Due Date for this form:

Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment under Title 18 of the United States Code, 18 U.S.C. § 1001.

Heather Kirby
2015
[e-mail]
Q Link Wireless LLC
7702327805 ext.
479018
Page 13
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Certification - Agent / Carrier FCC Form 481Data Collection Form OMB Control No. 3060-0986/OMB Control No. 3060-0819
July 2013
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>

Certification of Agent Authorized to File Annual Reports for CAF or LI Recipients on Behalf of Reporting Carrier
TO BE COMPLETED BY THE AUTHORIZED AGENT:
Telephone number of Authorized Agent or Employee of Agent:
Signature of Authorized Agent or Employee of Agent:
Name of Authorized Agent or Employee of Agent:
I, as agent for the reporting carrier, certify that I am authorized to submit the annual reports for universal service support recipients on behalf of the reporting carrier; I have provided
the data reported herein based on data provided by the reporting carrier; and, to the best of my knowledge, the information reported herein is accurate.
Date:
Printed name of Authorized Agent or Employee of Agent:
Title or position of Authorized Agent or Employee of Agent
Name of Reporting Carrier:
Study Area Code of Reporting Carrier:Filing Due Date for this form:
Printed name of Authorized Officer:
Name of Reporting Carrier:
Study Area Code of Reporting Carrier:
Title or position of Authorized Officer:
Telephone number of Authorized Officer:
Filing Due Date for this form:
TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING ANNUAL REPORTS ON THE CARRIER'S BEHALF:
Certification of Officer to Authorize an Agent to File Annual Reports for CAF or LI Recipients on Behalf of Reporting Carrier
I certify that (Name of Agent)_______________________________________________________ is authorized to submit the information reported on behalf of the reporting carrier. I
also certify that I am an officer of the reporting carrier; my responsibilities include ensuring the accuracy of the annual data reporting requirements provided to the authorized
agent; and, to the best of my knowledge, the reports and data provided to the authorized agent is accurate.
Date:
Name of Authorized Agent:
Signature of Authorized Officer:

Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment under Title 18 of the United States Code, 18 U.S.C. § 1001.
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment under Title
18 of the United States Code, 18 U.S.C. § 1001.

Heather Kirby
07/01/2014
2015
Regulatory Specialist
[e-mail]
8006101540 ext.
479018
7702327805 ext.
06/30/2014
479018
CEO
Q Link Wireless LLC
Issa Asad
7702327805 ext.
Q Link Wireless LLC
06/30/2014
07/01/2014
CERTIFIED ONLINE
Heather Kirby
Expert Telecom Compliance, Inc.
Expert Telecom Compliance, Inc.
Expert Telecom Compliance, Inc.
CERTIFIED ONLINE
479018
Q Link Wireless LLC
Attachments
<813>

<a3>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
(800) Operating Companies FCC Form 481
Data Collection Form OMB Control No. 3060-0986
July 2013
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<810>Reporting Carrier
<811>Holding Company
<812>Operating Company

/OMB Control No. 3060-0819

Heather Kirby
N/A
2015
Q LINK WIRELESS
[e-mail]
Q LINK WIRELESS LLC
Q Link Wireless LLC
7702327805 ext.
N/A
QUADRANT HOLDINGS GROUP LLC
479018
479018
Form 481 section 1210
Q LINK WIRELESS LLC
Lifeline Rates, Terms & Conditions
Plan 1: 68 Monthly Minutes Plan*
68 anytime minutes per month (unused minutes rollover) (texts are one-third of one minute, i.e. 3 texts = 1 minute)
Net cost to Lifeline customer: $0 (free)

This package includes:
 Free International Long Distance to countries designated at www.qlinkwireless.com
Plan 2: 125 Monthly Minutes Plan* 125 anytime minutes per month (unused minutes rollover)
(texts are one minute, i.e. 1 text = 1 minute)
Net cost to Lifeline customer: $0 (free)
Plan 3: 250 Monthly Minutes Plan* 250 anytime minutes per month (unused minutes do not rollover)
(texts are one minute, i.e. 1 text = 1 minute)
Net cost to Lifeline customer: $0 (free)
Tribal Plan: 1000 Monthly Minutes Plan* 1000 anytime minutes per month (unused minutes do not rollover)
(texts are one minute, i.e. 1 text = 1 minute)
Net cost to Tribal Lifeline customer: $0 (free)

*All packages include:
 Free handset
 Free calls to Customer Service
 Free calls to 911 emergency services
 Free access to Voicemail, Caller-ID, and Call Waiting features
 Free Domestic Long Distance

____________________

Additional Minutes 50 minutes = $10 150 minutes = $30 500 minutes = $50
100 minutes = $20 200 minutes = $35 unlimited minutes = $60

Complete program terms and conditions located at www.qlinkwireless.com