20180131Cingular Wireless Form 555.pdf

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John D. Sisemore
AT&T Services, Inc.
I 62 Roseheart
San Antonio, TX 78259
T:210-545-3519
F:214-202-5076
John.Si semore(a)att.conr
AT&T
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RECE IVED
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: i i li-lT;i'S C0h4MlSSlONVia Email
January 31,2018
Ms. Diane Hanian
Commission Secretary
Idaho Public Utilities Commission
472W. Washington
Boise, ID 83720-0074
secretary@puc. idaho. gov
Re: FCC Form 555. Annual Lifeline Elieible Telecommunications Carrier Certification
Form for New Cineular Wireless PCS. LLC ("AT&T MobiliW")
Dear Ms. Hanian:
As required by the FCC in its February 6,2012 Released Order in WC Docket No. 1l-42,
attached is a copy of AT&T Mobility's ldaho FCC Form 555 filed with the FCC.r These results
must be provided to the Commission, the Universal Service Administrative Company ("USAC"),
and to the states and tribal governments.
Please contact me with any questions or concems you may have at [phone].
Sincerely,
)* -.5-
cc
John Sisemore
Director - Regulatory
Carolee Hall, ID PUC
Margaret Thomson, Esq
Attachment
' AT&T Mobility filed its FCC Form 555 online with USAC. Once a carrier enters its six-digit study area code
("SAC") into USAC's online FCC Forrn 555, the online tool automatically populates a name associated with that
SAC. In solne cases, this automatically generated name differs from (e.g., is an abbreviated version of) the legal
entity name for AT&T Mobility's eligible telecommunications carrier affiliate.
Annual Lifeline Eligible Telecommunications Carrier Certification Form All carriers must complete all or portions
of all sections Form must be submitted to USAC and filed with the Federal Communications Commission
IMPORTANT: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 31't (Annually)
Does the reporting company have affiliated ETCs? yes @ No @
Provide a list of all ETCs that are ffiliated with the reporting ETC, using page 4 and additional sheets if necessary. Affiliation shall be
determined in accordance with Seclion 3(2) of the Communications Act. That Section defines "af/iliate" as "a person that (directly or indirectllt)
owns or controls, ts owned or controlled by, or is under common ownership or control with, another person." 47 U.S.C. S 153(2). See also 47
c.r'.R. .{ 76.t 200.
Affiliated ETC's SAC Affiliated ETC's Name
479006 143029765
Study Area Code (SAC) Service Provider Identification Number (SPIN)
(An Eligible Telecommunications Carrier (ETC) musl provide a certification /brm.fbr each SAC through which it provides Ldbline sen,ice).
2017 lD Cingular Wireless
Recertification Year
N/A
State ETC Name
New Cingluar Wireless PCS, LLC
DBA, Marketing, or Other Branding Narne
(lf same as ETC natne, list "N/A" Do lpl leave blank)
Holding Company Name
(lJ same as ETC name, list "N/A" Do not leave blank)
t
ETCs Subject to the Non-Usage Requirements
All ETCs must complete the appropriate check-box. ETCs that do not assess and collect a monthlyfeefrom their Lifeline ytbscribers are subject
to the non-usage reEirement.r. ETCs subject to the non-usage requirement.s must indicate the number of subscribers de-enrolled by month in
Sectbn 4. ETCs that only assess a .fee but do not collect such.fees are subject b the non-usage requirements and must ulso indicute the rutmber of
subscribers de-enrolled by month.
Is the ETC subject to the non-usage requirements? Yes @ No @l
l/ yes, record the number of subscribcrs de-enrolled./itr non-Ltsage by month in Block Q below.
P 0
Month Subscribers De-Enrolled for Non-Usage
January 0
February 0
March 0
April 0
May 0
June 0
July 0
August 0
September 0
October 0
November 0
December 0
Total Subscribers 0
For purposes of this filing, an officer is an occupant of a position listed in the article of incorporation, articles of formation,
or other similar legal document. An officer is a person who occupies a position specified in the corporate by-laws (or
partnership agreement), and would typically be president, vice president for operations, vice president for finance,
comptroller, treasurer, or a comparable position. If the filer is a sole proprietorship, the owner must sign the certification.
Initial Certificatiotl All ETCs must complete rhis section
I certify that the company listed above has certification procedures in place 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; 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 cornpany named above. I am authorized to make this certification for the Study Area Code listed
above.
JFDInitial
2
Minimum Service Level
I certify that the company listed above is in compliance with the minimum service levels set forth in the 47 CFR Section
54.408.
I am an officer of the company named above. I am authorized to make this certification for the SACs listed above.
Initial JFD
Annual Recertification
Do nol leave empty bloclcs. If an ETC has nothing to report in a block, enter a zero.
Report the number of Lifeline subscribers due for recertification by month (January-December)
A. Subscribers eligible for recertification by anniversary monthB. Subscribers de-enrolled prior to recertification attempts
C. Total number of subscribers ETC is responsible for recertifying (A-B)
Recertification Methods
State of federal databaseD. Subscribers recertified through ETC access to state or federal database by anniversary month
the number of subscribers verified access to a state or federal database.
E. Name of the data source(s) used to verify consumer eligibility:
ETC Direct ContactF. Subscribers contacted by ETC directly to recertify (You rnay also use this section to report subscriber initiated recertifications).
the number of Lifehne subscribers the ETC contacted to obtain recertification of
G. Subscribers who failed to recertify through ETC direct outreach attempt
the number of Lifeline subscribers de-enrolled due to or to the ETC's outreach
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year
Total
A.0 0 0 0 0 0 0 0 0 0 0 1 1
B.0 0 0 0 0 0 0 0 0 0 0 0 0
C.0 0 0 0 0 0 0 0 0 0 0 1 1
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year
Total
0 0 0 0 0 0D,0 0 0 0 0 0 0
May Jun Jul Aug Sep Oct Nov Dec Year
Total
Jan Feb Mar Apr
F 0 0 0 0 0 0 0 0 0 0 0 0 0
Jan Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year
Total
Feb
G.0 0 0 0 0 0 0 0 0 0 0 0 0
3
H. Subscribers who recertified through ETC direct outreach attempt
the that recertified ETC's outreach
Third Party
I. Subscribers whose eligibility was reviewed by state administrator, third party administrator, or USAC
the number of Lifeline subscribers contacted a state administrator third or USAC for the of recertification.
J. Name of third party administrator used to verify subscriber eligibility:
USAC
K. Subscribers de-enrolled as a result ofa third party recertification attempt
the number ofsubscribers as a result of or to outreach from a state third administrator or USAC.
L. Subscribers who recertified through a state administrator, third party administrator, or USAC's recertification effort
the number of subscribers that recertified a from a state administrator,third adrninistrator.or USAC
Certification:
Recertifi cation Method: Database
I certify that the company listed above has procedures in place to recertiff consumer eligibility by relying on a database. I
am an officer of the company named above. I am authorized to make this certification for the SAC(s) listed above.
Initial
4
May Jun Oct Nov Dec Year
Total
Jan Feb Mar Apr Jul Aug Sep
0 0H00000000000
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
l.0 0 0 0 0 0 0 0 0 0 0 1 1
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year
Total
K.0 0 0 0 0 0 0 0 0 0 0 0 0
Year
Total
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
L,0 0 0 0 0 0 0 0 0 0 1 10
Recertification Method: ETC
I certify that the company listed above has procedures in place to recerti$r 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. I am an officer of the company named above. I am authorized to make this
certification for the SAC(s) listed above.
Initial
Recertification Method: Third Party
I certify that the company listed above has procedures in place to recertify consumer eligibility by relying on an
administrator. I am an officer of the company named above. I am authorized to make this certification for the SAC(s)
listed above.
161ix1 JFD
No Subscribers
I certify that my company did not claim federal low income support for any Lifeline subscribers for the current Form 555
data year. I am an officer of the company named above. I am authorized to make this certification for the SAC listed
above.
Initial
Signature Block
By signing below, I certify that the company listed above is in compliance with all federal Lifeline certification
procedures. I am an officer of the company named above. I am authorized to make this certification for the Study
Area Code (SAC) listed above,
Signed,
James F. Dionne, Asst. Secretary James F. Dionne, Asst. Secretar
Signature of Officer
[e-mail]
Email Address of Officer
Huong DiRocco
Person Completing This Certification Form
Printed Name and Title of Officer
Jan 30, 2018
Date
5104441766
Contact Phone Number
y = 1A+K)N = (D+F+r)O = M/N*100
Total number of subscribers de-enrolled as
a result of recertification
Total number of subscribers ETC is
responsible for recertifying
Percent of subscribers due for
recertifi cation who were de-enrolled
0 1 0.0%
5
Affiliated ETCs
SAC Name
549004 ATandT Corp.
639005 Cingular Wireless
259908 Cinqular Wireless
39901 5 Cinoular Wireless
52991 0 Cingular Wireless
53901 0 ATandT Mobility LLC
215191 BellSouth Telecommunications LLC
225192 BellSouth Telecommunications LLC
2351 93 BellSouth Telecommunications LLC
245194 BellSouth Telecommunications LLC
255181 BellSouth Telecommunications LLC
265182 BellSouth Telecommunications LLC
275183 BellSouth Telecommunications LLC
285184 BellSouth Telecommunications LLC
2951 85 BellSouth Telecommunications LLC
345070 lllinois Bell Telephone Company
325080 lndiana Bell Telephone Company lncorporated
31 5090 Michigan Bell Telephone Company
5551 73 Nevada Bell Telephone Company
545170 Pacific Bell Telephone Company
269905 Cingular Wireless
279010 Cingular Wireless
289912 Cingular Wireless
31 9026 Cingular Wireless
38901 s ATandT Mobility LLC
409004 ATandT Mobility LLC
449022 Cingular Wireless
61 9004 Cingular \Mreless
405211 Southwestern Bell Telephone Company
415214 Southwestern Bell Telephone Company
445216 Southwestern Bell Telephone Company
3051 50 The Ohio Bell Telephone Company
335220 Wisconsin Bell lnc.
209012 Cingular Wireless
6