20160128CenturyTel of the Gem State 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 Fomr 555
November 2014
Approved by OMB
3060{819
Annual Lifeline Eligible Telecommunications Carrier Certification Form
All carriers must corylete all or portions of all sections
Form must be submiued to USAC and filed with the Federal Cornmunications Commission
IMPORTANT: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 31n (Annuatly)
472223
StudyArea Code (SAQ
(An Elisible Telecommuniutions Carrier (ETC) must provide a certificationformfor each SAC through which it provides Lifeline sentice).
lD CenturyLink CenturyTel of the Gem State (Nevar
State
CenturyLink
ETCName
CenturyLink
DBA. Marketins or Other Brandine Name
(If saie as ETC nan7e, tist "N/A" Do not lei* tt*t*1 Holdins ComoanvName
(tf sane aimC "ime,lu "N/A" Do not leave blank)
Does the reporting company have affiliated ETCs?Yes @l No [d
Provide a list of all ETCs that are ffiliatedwith the reporting ETC, using page 4 and additional sheets if necessary. Afi.liafion shall be
determined in accordance wirt Section 3(2) of the Communications Aa. That Section defines "afiiliate" as "a person that (directly or indirectlf
owns or controls, is owned or controlled by, or is under common ownership or control with, another person." 47 U.S.C. g 153(2). See also 47
c.r.R. $ 76.1200.
Affiliated 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 parhrership agreement), and would typically be president, vice president for operations, vice president for finance,
comptroller, treasurer, or a conrparable position. If the filer is a sole proprietorship, the owner must sign the certification.
SSCSqJ.1 Initial Certification All ETCs must completethis section
I certify that the coupany listed above has certification procedures in place to:
A) Review income and program-based eligibility documentation prior to enrolling a consumer in the Lifeline progranr, and
that, to the best of my knowledge, the conrpany was presented with documentation of each consumer's household
income andlor program$ased eligibility prior to his or her enrollment in Lifeline; and/or
B) Confirm consumer eligibility by relying upon access to a state database and/or notice of eligibility from the state
Lifeline administrator prior to enrolling a consumer in the Lifeline program.
I am an officer of the company named above. I am authorizsd to rnake this certification for the Study Area Code listed
above.
Initi"l JMA
FCC Forrn 555
November 2014
Section 2: Annual Recertification
Do not leave empty blocks. If an ETC has nothing to report in a block, enter a zero
Recertilication Results :
K L
Number of
subacrlbers whose
eligibillty was
revlewed by state
adrinlstrator,
ETC access to eligtbiltty
databasg or by USAC
Number of
subscribers deenrolled or
scheduled to be deenrolled as
a result of ffnding of
ineligibiltty by state
admlnlstrator, ETC access to
eligibility databasg or USAC
0 0
Note: Ifany subscriberwas reviewed by an ETC accessing a state database or
by a state administrator and subsequently contacted directly by the ETC in an
attempt to recertify eligibility, those subscribers should be listed in Blocks F
lhrough J as appropiate and notin Blocks K and L. As a result, all subscibers
subject to recertification who were not de-enrolled prior to the recertification
attempt must be accountedfor in Block F or Block K
The total of Block F and Black K should equal the number repofied k Block
E.
support for any Lifeline subscribers for the February
I am an officer of the conryany nanrcd above, I am
Approvedby OMB
30604819
Certiflcation:
Based on the data entered aboye, initial the certification(s) below that apply. Both Certification A and B nay apply depending on the recertification
procedures in place for the SAC reporting on fiis fom. If Certification C applies, neither Cerlification A nor B may apply.
A.) I certiff that the corryany listed above has procedures in place to recerti$ the continued eligibility of all of its
Lifeline subscribers, and that, to the best of my knowledge, the company obtained sigrred 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 corrpany named above. I am authorized to make this certification for the SAC listed
above.
Initial JMA
AND/,RB.) I certit/ that the corpany listed above has procedures in place to recertify consumer eligibility by relying on:
Results are provided in the chart above in
Blocls K through L. I am an officer of the company named above. I am authorized to make this certification for the
SAC listed above.
Initial
OR
C.) I certiff that my corryany did not claim federal low income
Form 497 data month for the current Form 555 cale,ndar year.
authorized to make this certification for the SAC listed above.
Initial
A B C D E= (A_B_C_D)
Number of subscribere
clalmd on February
FCC Form497 of
current Form 555
calendar year
(February dttu monthl
Number of llnes
clatmd on February
FCC Form497 of
current Form 555
calendar yerr
provided to wirdine
resellers
Number of subscrlbers claimed on the
February FCC Form 497 that were
inidallv enrolled in the current Form
555 calendar year
(These subscribcrs did not have Lifeline
semice pfior tu fanuary I of the cwreat 555
calendar yean)
Number of subscribers
de-enrolled giq to
recertiffcation atteryt
by either the ETC, a
strte administrator,
access to an eligibility
databasg or by USAC
Number of
subscribers ETC is
responsible for
recertifying for
current Form 555
calendtr year
23 0 1 1 21
F G H= G-c)I J = (E+I)
Number of
subscribers ETC
coutacted directly to
recertify eligibility
through attestation
Number of
sub,scribers
responding to ETC
contrct
Number ofnon-
responding
subscribers
Number of subscribers
respondng that they are
no longer ellgitte
(Thls shonld be a subset of Block
G.)
Number of subacribers de
emolled or scheduled to be
deenrolled as a result of
non-r€sponse or response of
ineligtbility from ETC
recerfifrcation ottempt
21 I 13 0 13
FCC Form 555
November 2014
Ss,sliqji De'enroll Percentage
Using the data entered in Section 2 , conplete the chart below to find the percentage of subscriben de-enrolled for this ETC.
M =(F+IO 11= (J+L)o=((N=M)*100)
Number of subscribers that the
ETC attempted to recerdfy dlrecdy
q tlrough a state adminlstrator,
ETC accecs to a state database, or
by USAC
(This should qual the number
reponed in Block E)
Number of
subscribers de-
enrolled or scheduled
to be de- enrolled ar a
result of non-response
or ineligibility
Percentage of subscribers
de-enrolled or scheduled to
be de-enrolled ss e result of
ineligibility or non-respoBlre
21 13 61.9o/o
Sectiqnlli PrePaidETCs
All ETCs must complete the appruprinte check-box; pre-paid ETCs must complete all of Seaion 4. Pre-paid ETCs goerally do not assess or collect a
nonthlyfeefum their Lifeline subscribers. ETCs that only assess afee but do not collect such fees are pre-paid ETCs and must complete the
chart below.
Is the ETC Pre-Paid? Yes [l[ No [d
If Yes, record the number of subscribers de-enrolled for non-usage by month in Block Q below.
P o
Month Subscribers De-Enrolled for Non-Usase
January 0
February 0
March 0
Aoril 0
May 0
June 0
July 0
Auzust 0
September 0
October 0
November 0
December 0
Total Subscribers 0
Signature Block
fuproved by OMB
3060-0819
By signing below, I certiS that the company listed above is in conpliance with all federal Lifeline certification
procedures. I am an officer 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 ofSiped, Revenues
Certified Online
Sipature of Officer Printed Name and Titleof OfEcer
[e-mail] 0111412016
Email Addre,ss of Officer Date
Pam Hankins 318-388-9174
Person Completing This Certification Fomt Contact Phone Number
3
FCC Form 555
November 2014
Approved by OMB
3060-08 19
Affiliated ETCs
SAC Name
160138 Cenhrrvlink Ilnited Telnhone Co. of New .Iersev (FKA En
170209 CanhrrvT.inlr I Tnifc.l Tclenhnne Co nf Pennsvlvanin FKA I
190254 lapnfrrnrT inL Cantral Tclcnhnne /-n nf Viroinie l,FKA l.-mh
I 90557 Cenh rrvlink I Inifed Tel enhon e-Sorrtheast Inc - (FK A F.m hr
210741 Cenfirrvl.ink-F.mharn Flnrida Tnc (FKA F.mhato)
220356 Cenfi rrvT.ink Cna<tel I Itilities Inc
230470 Centurvlink Carolina Teleohone and Teleeraoh Co FKA E
230471 Centurvlink Central Telenhone Co.-North CarolinaGKA I
2?04R5 faanfrrnrT inlz l\rfahTal Inn
240506 Cenhrrvlink ITnited Telenhnne of the Carolina-s-SC fFKA I
250298 Centurvlink Gulf Telenhone ComDanv
259788 Cenhrrvlink CenturvTel of Alabama fNorthern and Southe
259789 Cenhrrvl.ink CenturvTel of Alabama fNorthem and Southe
CenfrrrvT.ink CanfirrvTel nf Cerrfral T.orrisiana [.T.C
270424 CcnfirruI .inlc CenfrrrvTcl of Snrrfheasf T.nrtisiena T.T.C
270427 CenhrruT.ink CenhrrvTel nf Chafham T.LC
270471 anfrrrrT inlz /ranfrrnrTal nf Nnrthrrracf f nrricianc Tna
270434 CentrrrvT.ink CenhrrvTel of Evanseline T.T,C
270436 (-enhrrvl .inlr CenfirnrTel nf Nnrth T.nrrisana T-T.C
).10479 l-antrrnrT inb laanfirnrTol n€Pinccnli T f a
270440 anfrrnrT inlz (aantrrnr'Icl af Facf T nrricirnq T f f'
270442 fienfirnrT inlr (-anfrrnrTcl nf Snrrfhrrrccf T nrrician q I I C
280458 faerfrrnrT inlz franfrrarTcl nf Nnrfh l\-tficcissinni Tnn
290552 Cenhrrvlink CenhrrvTel of Adamsville Inc.
2905s7 CnnhrruI .inlr CcnfirruTcl nf Claihome Inc
290567 Cenhrrvl.ink I Inited Telenhone-Southea-st Inc- (FKA Emh:
290574 CenhrrvT.ink CenhrrvTel of Ooltewah-Collesdale Inc.
300630 f'enhrruI.inlr CenfirnrTel nf Ohin Tnc
30066 I Centurvlink United Teleohone Co. of Ohio FKA Embaro
3t0671 Centurvlink CenturvTel of Midwest-Michisan Inc.
3 10689 Centurvlink CenhrvTel of UDDer Michiean Inc.
110702 pnfirroT inlr (-enfirruTel nf l\rfichicqn fnn
3 10705 Cenhrrvl .inlr CenfirrvTel nf Nnrther'n Michionn lnc
32074'.1 CenturvTel of Central Indiana Inc.
32080r Cenhrrvlink CenhrrvTel of Odon Inc-
320832 CentrrrvT.ink Ilnited Telenhone Co. of Indiana fFKA Emha
33084 r Cenhrrvlink CenhrrvTel of the Midwest-Wisconsin fNorth
3308s7 Centurvlink CenturvTel of the Midwest-Wisconsin (North
330877 Centurvlink CenturvTel of Fairwater-Brandon-Alto LLC
330884 Centurvlink CenturvTel of Forestville LLC
330895 Centurvlink CenturvTel of Wisconsin LLC
330898 Centurvlink CenturvTel of Laresen-Readfi eld LLC
330913 Centurvlink CenturvTel of Monroe Countv LLC
330922 Centurvlink CenturvTel of the Midwest-Wisconsin ("North
330924 Centurvlink CenturvTel of the Midwest-Kendall LLC
33093 1 Centurvlink CenturvTel of Southern Wisconsin LLC
130934 Cpnhrruf inL CenfirruTel nf the Midruesf-Wiscnnsin fNnrth
330950 CentrrruT inlr CpnfirruTpl nf Nnr.fhrve<f \tr/ie.nncin T.I .C
330956 CenfirruT .inlr (-cnhrrvTcl nf Nnr"fhern'Wi scnnqin T .t -C
330959 Cenfi rruT .inlr /-pntrrruTel nf fhp Midwesf-Wiscnnsin fNnrfh'
FCC Form 555
November 2014
Approved by OMB
3060-08 l9
Affiliated ETCs
SAC Na:ne
330970 (aenfirruT inlr CenhrruTpl nf the Midrrpcf-Wiqenncin fNnrth
331155 Ccnhrrul.inlr Telenhnne ITSA nf Wiqnnn<in 1.[.C
3i1 l5S Cenfrrrvlink CenfirrvTel of Central Wisconsin L[,C
141051 (- anl-rrnrf inlz Gellqtin P irrer (-nmmrrninqfinns T T (-
1\1 125 Ilanfrrnrf inlr (-an?rrnr'I'el nf Chaqfcr Tnc
351274 Cenhrrv[.ink CenhrrvTel of Pnsfville Inc
355141 Centrrrv[ .ink Ourest Cornnrstion
36t445 Cenfrrrvl-ink CentrrrvTel nf Minnesofa Tnc
761 4\6 Centrrrvlink - F-mharn Minnesnfa Tnc fF'KA F-mharn\
155142 /r anfi rnrT inlz flrrrecf ('nmnrqfinn
37t59s CenturvLink United Teleohone Co. of the West GKA Emb
375143 Ccnfr rrvl .inlr fhvecf fl nrnnrafinn
385144 (-pnflrruf .inlr Owe cf Cnrnntafinn
395145 Cenfi rruT.inlr C)wecf Cnrnorefinn
401t42 Canfirrvl .ink CenhrruTel nf Il nsqellwil le
401t43 Centurvl-ink CenturvTel of Ru^ssellville
401144 flanfirnrl'al nf l\rf amr nfh Qa#n a Tanlrcnnrri I I e
401 70s f"entrrruf .inlr (-pnfirroTel nf Adrqnsec Tnn
401711 (-enfrrruTel nf Mnttnfein Ffnmc Tnr:
4017)i faanfrrnrT inlr (aanfirnrTal nf Tlar{'Fialrl Tnn
401727 /apnfirnrT inlz faenfirnr'l'al af Qnrrfh A rlranceq Tnn
411717 f-enfirnrf inlz TTnitad Telanhnne (an-Fqcfem Ilqnsqs fFI{A E
411842 (-anfirnrf inlr TTnitorl Tplanhnnc f-n - I(ansec fET{A Fmhqrr
41 1957 Cenhrrvl.ink-F.mharo Missorrri Inc (FKA Emharo)
42tts1 Snenfra Cnmmrrnicafinn< Grnrrn | .I .A. dA,le CenhrrvT.inlr
4219s7 frenfrrrof inlr-Fmhqrn lzfiscorrri tnc (E'KA Fmharn'l
429784 fenfirrof .inle CenhrruTpl nf Missnrrri I.I .(-
429785 (lenfirrvT.inlr CenfirrvTel nf Missnrrd T.I .C
429786 Centurvlink CenturvTel of Missouri LLC
429787 Cenhrrvlink CenturvTel of Missouri LLC
442084 Centurvlink United Teleohone Co of Texas Inc. FKA Em
442101 Centrrrv Link CenhrrvTel of T.ake Dallas Inc.
442t14 Centurvlink Central Teleohone Co. of Texas FKA Embaro
442t17 Centurvlink CenturvTel of Port Aransas Inc.
442140 CenhrrvT.ink CenhrrvTel of San Marcos Inc.
455 I 01 Centrrrvl,ink Owest Comorati on
46218s Centurvlink CenturvTel of Eaele Inc.
462t87 Cenhrrvl -inlr The F.l Pecn (lnrrntv Telenhnne Comnnnv
462208 Centurvlink CenturvTel of Colorado Inc.
455102 Centurvlink Owest Comoration
472223 Centurvlink CenturvTel of the Gem State fNevada)
472225 CenturvLink CenturvTel of Idaho Inc.
475103 llenhrrvl -ink Owesf Cnrnorafinn
475162 Cenfr rrvl .ink Owesf Cnrnorafi nn
482249 CenturvLink CenturvTel of Montana Inc.
485 I 04 Centr rrvT .ink Owesf Cornorefi nn
492274 Cenhrrvl.ink CenturvTel of the Southwest O{ew Mexico)
49510s fl enfirruT .inlr Clwesf (-nrnnrafinn
505107 CcnhrruT .inlr f)rrcsf flnrnnrefinn
5 1 1595 Centrrrvl.ink Ilnifed Telenhone Co- of the West (FKA F.mh
FCC Form 555
November 2014
Approved by OMB
30604819
Affiliated ETCs
SAC Name
412299 CenhrrvT.inlr CenhrnrTel of Wwomino Tnc
5 15 108 Cenhrruf.ink Owecf Comnrefinn
522400 Cenhrrvl.ink I Inited Telenhone Co of the Northwest(FKA I
522408 (aenfirnrf inlr frenfirnrTel nf \l/echinofnn fnc
s22410 Cenhrru[.ink CenfirrvTel of Cowiche Inc
525161 (lcnfirnrl inle flrrrecf (anmnrqfinn
53236t CenhrrvT.ink CenhrrvTel of Oreson Tnc CenhtrvTel of F.a
532400 Centurvlink United Teleohone Co of the NorthwestGKA I
s35 I 51 Cenhrrvl.ink Owest Cnrnorafion
552223 (-entrrruI inlu (-enfirruTel nf fhp flcm Sfefe fNevadn\
552348 f.enfirruT inle (-enfrql Tplenhnne Cn nfNpwadn t"EI{A\