20160128CenturyLink QC [475162] ETC Form 555.pdf

Centuryl-ink
1600 7th Avenue, Room 1506
Seattle, Washington 98191
Phone [phone]
Facsimile [phone]
Maura E. Reynolds
Paralegal
Regulatory Law Dept.
January 26,20L6
Jean D. Jewell, Secretary
ldaho Public Utilities Commission
472 West Washington
Boise, ldaho 83702-5983
Dear Ms. Jewell:
RECEIVED
20lt JAt{ 28 &t{ ll: lr9
iL]AHC PUBLIC
sI7d
TrrY Centurylink'
iiT tLl itEs 00tdt{tsstoN
&NR-T- /b-o r
Pursuant to the Federal Communications Commission's Report ond Ordel requiring
eligible telecommunications carriers to re-certify the eligibility of their Lifeline
subscribers and to report the results to the Federal Communications Commission,
Universal Service Administrative Company and to state commission and Tribal
governments, Centurylink hereby submits its 2015 Lifeline re-certification results for
each FCC study area (company) in ldaho.
Please do not hesitate to contact me should you have any questions regarding this filing.
1 ln the Matter of Lifeline and Link Up Reform and Modernization, Lifeline and Link Up, Federal-State Joint Board
on Universal Service, Advancing Broadband Availability Through Digital Literacy Training, Report and Order and
Further Notice of Rulemaking,2T FCC Rcd 6656, 67L5-L61i132(20L21;47 C.F.R. S 54,416. Also see Public Notice,
28 FCC Rcd 12947 (2013).
FCC Form 555
November 2014
Approved by OMB
30604819
Annual Lifeline Eligible Telecom m rrni cations Carrier Certification Form
All carriers must complete all or portions of all sections
Form must be submitted to USAC and filed with the Federal Communications Cornmission
IMPORTAITIT: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 31i (Annually)
475162
StudyArea Code (SAC)
(An Eligible Teleconmunimtions Carrier @TC) must provide a cenificationformfor each SAC through which it proides Lifeline seruice).
lD CenturyLink Qwest Corporation
State
CenturyLink QC
ETCName
CenturyLink
DBA. Marketins or Other Brandins Name(f sane as ETC nof,", l*t "N/A" Do not led,e ttan*)
116ldinu ComoanvName
(If sane ai PrC ninu,list "N/A" Do not leave blank)
Does the reporting company have affiliated ETCs? Yes [[l No [d
Provi.de a list of all ETCs that are ffiliatedwith the reporting ETC, using page 4 and additional sheets if necessary. Afiliation shall be
determined in accordurce with Section 3Q) of the Communications Act. That Section defines "afiliate" as "a person that (directly or indirectly)
owns or controls, is ownel or controlled by, or is under common ownership or control with, another person." 47 U.S.C. S 153@. See also 47
c.r.x. $ 76.1200.
AfEliated ETC's SAC Affiliated ETC's Name
-- See attached worksheet --
For purposes of this filing an officer is an occupant of a position listed in the article of incorporation, articles of
formation, or other similar legal document. An officer is a person who occupies a position specified in the corporate by-
laws (or partnership agreement), and would typically be president, vice president for operationso vice president for finance,
corytroller, freasurer, or a comparable position. If the filer is a sole proprietorship, the owner must sign the certification.
Eg;gdq1Ji Initial Certilication All ETCs must completethis section
I certifothat the corryany listed above has cerdficationprocedures in place to:
A) Review income and program-based eligibility documentation prior to enrolling a consumer in the Lifeline prograrq and
that, to the best of my knowledge, the company was presented with documentation of each consurrcr's household
income and/or program-based eligibility prior to his or her enrollment in Lifeline; and/or
B) Confirn 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 conrpany named above. I am authorized to make this certification for the Study Area Code listed
above.
rniuat JMA
FCC Form 555
November 2014
Section 2: Annual Recertification
Do not leave empty blochs. If an ETC has noihing to rqort in a bloch enter a zero.
Recertilication Results :
K L
Number of
subscribero whose
eltgibiltty war
reviewed by state
admlnlstuator,
ETC access to eligibility
databasg or by USAC
Number of
subscribers de-enrolled or
echeduled to be deenrolled as
a result offindlng of
he[gibility by state
addnlstrator, ETC access to
ellgibility database, or USAC
0 0
Notez If any subscriber was reviewed by an ETC accessing a state database or
by a state administrator and subsequently contactd directly by the ETC in an
attempt to recertify elgibility, rtose sabscibers should be listed in Blocks F
through J as appropriate and not in Blocks K and L. As a result, all subscribers
sttbject to recertification who were not de-enrolled pior to the recertification
attempt rrutst be accountedfor in Block F or Block K
The total of Block F and Block K should eqaal the nunber rcported in Block
E.
Approved by OMB
3060-08 I 9
Cerffication:
Based on the datd entered above, initial the certification(s) below that apply. Both Certifi.cation A and B nay apply depending on the recertification
procelures in placefor the SAC reporting on fiis form. If Cetification C applies, neiiher Certiftcation A nor B may apply.
A.) I certify that the company listed above has procedures in place to recertiff the continued eligibility of all of its
Lifeline subscribers, and that, to the best of my knowledge, the company obtained siped certifications from all
subscribers attesting to their continuing eligibility for Lifeline. Results are provided in the chart above in Blocks F
through J. I am an officer of the company named above. I am authorized to make this certification for the SAC listed
above.
Initial JMA
AND/.RB.) I certiff that the conpany listed above has procedures in place to recertify consumer eligibility by relying on:
Results axe provided in the chart above in
Blocks K through L. I am an officer of the company named above. I am authorizedto make this certification for the
SAC listed above.
Initial
ORC.) I certiff that my company did not claim federal low income support for any Lifeline subscribers for the February
Form497 data month for the current Form 555 calendar yeax. I am an officer of the coupany named above. I am
authorized to make this certification for the SAC listed above.
Initial
A B C D E= (A_B_C_D)
Number of eubscribers
claimed on February
FCC Form497 of
current Form 555
calendar year
(February data month)
Number of Iines
daircd onFebruary
FCC Form497 of
curent Form 555
calendar year
provided to wirellne
resellers
Number of subscribers clalmed on the
February FCC Form497 thatwere
inifiallv enrolled in the current Form
555 calendar year
(Thesc subscribers did not have Llfeliae
service prtor to Janutry I ofthe current 555
calendar year.)
Number of subacrlbers
de-enrolled Bglg to
recertificrtion atteryt
by either the ETC, a
state edministrator,
access to an eligibility
database, or by USAC
Number of
subscribers ETC is
responsible for
recertifying for
current Form 555
cdendar year
439 0 6 39 394
F G E = (F-G)I J = (E+I)
Number of
subscribers ETC
contacted direcfly to
recerdfy eltglbility
through attestadon
Number of
subscriberr
responding to ETC
contact
Number ofnon
respondlng
subscrlbers
Number of subgcribers
responding that they are
no longer eligiHe
(Thls should be a subsd ofBlock
G,)
Number of subscribers de-
enrolled or scheduled to be
deenrolled rs a result of
non-response or response of
tneltgibflltty ftomETC
recerdficadon rttempt
394 138 256 0 256
FCC Form 555
November 2014
Section 3: De-enroll Percentage
Using the data entered in Section 2, complete the chart below to find the percennge of rubscibers de-enrolledfor this ETC.
M = (F+K)N= (J+L)O=(N=M)*100)
Number of subscrlbcrs that the
ETC attempted to recertify dlrecdyg through I state admlnlsfrotor,
ETC access to a state database, or
by USAC
(This should qaal the number
tqofid b, Bloc* E)
Number of
sub,scribers de-
enrolled or scheduled
to be de enrolled as a
result of non-response
or tneligibility
Percentage of subscrlbers
deenrolled or scheduled to
be de-enrolled as a result of
tneligibtlity or non-respome
394 256 64.970/o
Section 4: Pre'Paid ETCs
All ETCs must complete the apprcpriate check-box; pre-pai.d ETC.s must complete all of Section 4. Pre-paid ETCs gmenllydo not assess or collect a
monthlyfeefrom their Lifeline subscibers. ETCs that only assess a fee but do not collect such fees are pre-paid ETCs and must complete the
chart below.
Is the ETC Pre-Paid? Yes [@ No [Gil
If Yes, recod the number of subscibers de-enrolledfor non-usage by rnonth in Block Q below.
P o
Month Subscribers De-Enrolled for Non-Usaee
January 0
Februarv 0
March 0
April 0
Mav 0
June 0
July 0
Auzust 0
September 0
October 0
November 0
Decernber 0
Total Subscribers 0
Signature Block
Approved byOMB
3060-0819
By sigrring below, I certiff that the corpany listed above is in conpliance with all federal Lifeline certification
procedures. I am an ofEcer of the company named above. I am authorizad to make this certification for the
Study Area Code (SAC) listed above.
Jerry M Allen, Vice President ofSigred, Revenues
Certified Online
Signature of OfEcer
Jerrv.allen@centurvlink. com
Email Address of Officer
Pam Hankins
Person Completing This Certification Form
Prioted Narne and Title of Officer
01t1412016
Date
318-388-9174
Contact Phone Number
3
FCC Forrn 555
November 2014
Approved by OMB
3060-0819
Affiliated ETCs
SAC Name
150138 CcnhrruT.inlr I Tnite.l Tchehnne Cn nf Nerr Iercew fF'K A Fr
170209 Cenhrrvl.inlr Ilflited Te'lenhnne Cn of Pennsvlvania FKA I
190254 (apnfirnrf inlr (.enfral Telanhnnc fn nf Viroiniq t'E'KA trmh
t90567 Cenhrrv[.ink I ]nited Telenhone-Snntheast Tnc. (FK A F.mhr
210341 Cenhrrvl.ink-F.mharn F'lorida Tnc fF'K A F.mhero)
220356 CentrrrvT.ink Cnasfal I Itilifies Inc
230470 Centurvlink Carolina Teleohone and Telesranh Co FKA E
2304',71 Centurvlink Central Teleohone Co.-North CarolinaGKA I
23048s l'cnfirnzT inlz l\lfehTel Tnn
240506 (lpnfrrnrf inL I Tniterl Talanhnna nf thc Cqrnlinnc-Sfl fE'Il A
250298 CenhrrvT.ink Grrlf Telenhone Comnanv
2s9788 faaafrrnrf inL laanfrrar'l'al af A loLo-o fNlarfham onr{ Q.nrrlLa
259789 CenhrrvLink flcnhrruTel nf Alnhcmn fNorfhcrn and Snrrfhp
270423 Cenhrnrlink CenhrrvTel nf (lenfrel Lnuisiane T.I .C
270424 CenfirrvT -ink CenhrrvTel nf Smrfhensf T.nrrisinna T.T -C
270427 Centurvlink CenturvTel of Chatham LLC
270437 Cenhrrvlink CentrrrvTel of Northwesf [.nrrisiana Tnc
270434 Cenhrnrl.inlc CenhrnrTel of F.wenoelinc t.t.C
270436 CenhrnrT.ink CenfrrrvTel nf Nnrfh T.mrisana T -[.C
270439 (lanfirnrf inlr flcntrrnrTel nf Ilinoonld I t (-
270440 Cenhrrvl.ink CenhrrvTel of F.asf Lnrrisiana LT.C
270442 Cenhrrvl.ink CenhrrvTel of Southwesf [.ouisiana LT,C
280458 Cenhrrvlink CenhrrvTel of North Mississinni Tnc
290552 Cenhlw[.ink CentrrrvTel of Adamsville Inc.
290557 Cenhrrvlink CenfirrvTel n{c Cleihorne Inc
290567 CenfirruT.inlr ITnited Telenhnne-Snrrfheesf Tnn fF'KA Fmhr
290574 Cenhrrvl .inlr CenhrrvTel nf Onlferrah-Cnlleodale Tnn
300630 Cenhrw[-inkCenhrrvTel of Ohin Inc
300661 Centurvlink United Teleohone Co. of Ohio FKA Embaro
310671 CenturvLink CenturvTel of Midwest-Michiean Inc.
3 1 0689 Centurvlink CenturvTel of Uooer Michiean Inc.
310702 CanhrrvT.inlr CenhrnrTel nf Michioan Tnc
3 10705 Centurvlink CenhrvTel of Northem Michisan Inc.
320747 CenturvTel ofCentral Indiana Inc.
32080 I Cenfrrnrl.inlr CenhrruTel nf f)dnn Inn
320832 CenhrrvT.inlr ITnited Telenhone Cn nf Indiana l-FKA F.mhe
33084 I Centurvlink CenturvTel of the Midwest-Wisconsin l'North
3308s7 CenturvLink CenturvTel of the Midwest-Wisconsin fNorth
330877 Centurvlink CenturvTel of F airwater-Brandon-Alto LLC
330884 Centurvlink CenturvTel of ForesWille LLC
330895 Centurvlink CenturvTe ofWisconsin LLC
330898 Centurvlink CenturvTe ofLaresen-Readfield LLC
3309 I 3 Centurvlink CenturvTe of Monroe Countv LLC
330922 Centurvlink CenturvTe of the Midwest-Wisconsin fNorth
330924 Centurvlink CenturvTe ofthe Midwest-Kendall LLC
33093 I CenturvLink CenturvTe of Southem Wisconsin LLC
330934 Cenfirrvlink CenfirrvTel nf f he Midrvect- Wi seonsin fNnr+h
330950 Centrrrvl -ink CenhrrvTel nf Northwest Wisconcin LI -C
330956 Centurvlink CenturvTel of Northern Wi sconsin LLC
330959 Cenh rnrT .i n lr Cenh rrvTel nf fhe Midrvesf -\tr"Ii c enn si n fNnrfh
FCC Form 555
November 2014
Approved by OMB
3060{8r9
Afliliated ETCs
SAC Name
330970 (rcnfirnrf inL f-enfirnrTel nf +he Midrvesf-Wiccnncin fNnrth
331rs5 Cenfirrof inL Telcnhnne TTSA nf Wicennsin Lf .C
3illss liantrrnrf inlz /aanfrrarTal nf flcnfrol \l/icnnnsin T.T (-
34t0s7 Centrrtvl.ink Gallatin River Cnmmnnicafions LLC
35tt26 Cenhrnrl.inlr CenfrrrvTel nf Chesfer Tnc.
35t274 Cenhrrvl .ink CenfrrrvTel nfPostville Ine
3ss 141 CcntrrrvT .inL f)urest Cnrnnrefion
36t44s Cenhrrvl.inlr CpnhrrvTel nf Minnesofa Inc
161 L\6 Canfirrvl.inL - F.mharn Minnesnfa Inc (FKA F.mharn\
36s142 Cenhrrvlink OT vesf Cnrnorefinn
37ts9s Centurvlink tlnited Teleohone Co. of the West GKA Emb
375 43 franfrrrof inL flrwccf (-nmnrqfinn
385 44 Ocnfrrnrf inL f'hwecf flnrnnrnfinn
395 45 Oentrrnrf inL f)rresf ('nrnnrntinn
401 42 (-pnfrrroT inL f'enfirroTcl nf Rrrqscllwille
401 43 flenfirruf .inlr CenfrrruTel nf Rrrssellwille
401 44 franfrrrr'l'al af \rf am m nfh (nrinc Ta ^1zo nnrri I 1 e
401705 CentrrwT.ink CenhrrvTel of Arkansas Tnc.
401711 CpnfirroTpl nf lVfnrrnfain Flnme Tnc
LO17)O /aanhrnrf inL /lanfrrnrl'al nf Par{fialrl Tnn
4017).1 (aanfrrxrf intz /raafrrnrl'cl nf (nrrfh A rlrcncqc Inr
4t1317 CenhrniT.ink I Inifed Telenhone Co-F.asfem Kansas fFKA F
41t842 CenfrrruI -ink I Tnifed Telenhone Co - Kensas (FKA F.mharr
41t957 Cenhrr-vT .ink-F.mharn Mi ssorrri Inc (FK A F,mbaro)
4211s1 Snectra Com m uni cati on s Groun LLC dlb / a Cenhrrvlink
421957 frenfirnrT inL-Emhqrn l\r{issnrrri Tnc fE'KA F.mhqrn\
429784 (lpnfnnrT inlr CcnfirroTel nf M ssnrrri T.I .C
425',78s (renfirroT .inlr CcntunrTcl nf Micsorrri T.T.C
429786 Cenhrrvl-ink CenturvTel of Missouri LLC
429787 Centurvlink CenhrrvTel of Missouri LLC
442084 Centurvlink United Teleohone Co of Texas Inc. FKA Eml
442101 Cenhrrv T.ink CenhrrvTel of Lake Dallas Inc.
442 t4 Cenhrrvl.ink Central Telenhone Co- of Texas FKA Embaro
442117 Cenhrrvl.ink Centr-rrvTel of Port Aransas Inc.
442140 Centurvlink CenturvTel of San Marcos Inc.
455 101 Cenhrrvl,ink Owest Comoration
46218s Centurvlink CenturvTel of Eaele Inc.
462187 Centurvl.ink The El Paso Countv Teleohone Comnanv
462208 Centurvlink CenturvTel of Colorado Inc.
46s102 Centurvlink Owest Comoration
472223 Centurvlink CenturvTel of the Gem State (Nevada)
472225 Centurvlink CenturvTel of Idaho Inc.
475103 Cenhrt-vlink f)uresf Cornorati on
47s162 Centrrrvl .inlr Owesf Cornnratinn
482249 Centurvlink CenturvTel of Montana Inc.
485 r 04 Centurvlink C)west Comoration
492274 (-enfrrrof inlr (-cnhrnrTel nf fhe Snuthuresf fNew Merricn\
4951 05 (-pnfi rrof .inlr l.)rxeef Cnrrrntaf i nn
5051 07 (1enhrruT.inle (.)weef Cnrnnrafinn
5l 1595 Centurvlink United Teleohone Co. of the West GKA Emb
FCC Form 555
November 2014
Approved by OMB
30604819
Affiliated ETCs
SAC Name
512299 (lenfirnrl inlr CenhrrvTel nf 'Wwomino Inc
5 15 108 CenhrruT.inlr Orveq,t Cnrnnrefion
522400 Cenhrrvl.ink Ilnited Telenhone Co of the Northwest(FKA I
522408 CenhrrvT.ink CenhrrvTel of Washinston Tnc-
s22410 flenfirnrT inlz flpnfirnrTal nf (-nrrinhe Inc
s25t6r (aanfrrxzf inL f'lrrracf (anmntcfinn
532361 Cenhrrvl.ink CenhrrvTel of Orepon Inc-- CenturvTel of Ea
532400 Cenhrvlink United Teleohone Co of the Northwest(FKA I
{?sr6?1r anfirnrl inlz f\uraqf (-nrnnrcfinn
552221 Cenhrrvlink CenhrrvTel offhe Gem State fNevada)
5s2348 Centrrrvlink Central Telenhone Co. of Nevada GKA)