20180613Rural Telephone CAF ICC.pdf

RURAL TELEPHONE COIVPANY
TO BE COMPLETED BY THE REPORTING CARRIER,
Certification of Officer as to the Accuracy of the CAF ICC Data Reported
oerlify that I am an ollicor of the roporting carrier; my nsponsibilltios lnoludo ensuring tha accuracy of the actual data repor(ed; and, to lhe best ot my
knowlodge, lhe lnformatlon reported on thls form ls accurato.
vame or R"*ftim cr,irrRural Telephone-.lpompany ' ldaho
of Aulhorlzed Of{icer
Vice-Presidenttillo or position ol Authorizod Oflicer
telephone numbor ot Authortzed omcer: (?:08) 366-26 1$1r.
StdV Area Code of Reoofiinq Caffler 472233 l,'..l,i',i 1fl'ff.!ffitoforrhrslorm 5/18/2018
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lmprlsonment under Title 1B of the Unlled Slates Code, 18 U.S.C. S 1001.
Ca(ier Cert
'''%z//-t//zw lo^,"05/30/18
TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING DATA ON THE CARRIER'S BEHALF:
Certification of Officer to Authorize an Agont to File Data Reported on Behalf of Reportlng Carrier
lc€dIfythat(Namgotegen0iraulhorlzedtosUbnlltlhelnformation'oporledonbehal,ollhe
reporllng carler. I also c€rllty lhal I am an orflcer o, the reporliilg csrrler; ory rosponslbllltlq includo enslrlng lhe aqcuracy of the dali provldod to the Authoriu ed
Agent; and, to the b6t of my krFwlodg!, lhe rotual datr provided lo lho Aqthorlzed Agent are acourato,
Namo orAurhorkod 4qsd Nalional Exchange CarrierAssociation, lnc. (NECA)
Name o, RoDonino 6rr,1"rRural Telephone Company - ldaho
Offier B
of A{-dhorized o*""rMichael
Tilte q posltim o( Authorlzed nrn"urVice-Pfesident
r.bphone nmber otA(hqizod oro*, (?99)-16,Q'?94"". ---
Study &oa Codo ot Remilinq Gsnier l+zzzzs lrii;1,1**rr.*e {or,his ro'm 6/18/2018 I
Peruns wi,truly makhg false 6talmenl6 on lhiE form c8n bo punlshed by fine q rorfeiture urder tho Comeunlcalhns Act o, 1934, 47 l.r.S.C. SS 502, 503(b), or flse or
lmprisonmenl under Title 18 of th6 Ljnited Slales Code. 18 U-S.C. S 1001.
TO BE COMPLETED BY AN OFFICER OF THE REPORTING CARRIER
Ce*ification of Officer lor Rate.of-Roturn Carrler Ellgibility for CAF/ICC Reoovery
I certify that I am an otficer of the reporting carrler and that, to the best of my knowledge, the ,eportkrg carrler on thir ,o.m certl0es that lt ha5
complied wtth Ellglbls Recovery 551.9171d| and Access Re.ovsy chargs S51.917(e) and is eligible to racctve the CAF ICC rupport requ€sted pursuant
to $s1.917(f),
Namo or Rooorrino c",,;", Ru ral TelepJSlng Com pa ny - ld a ho
Oa(e 05/30/18
M . Martell
Vice-President
letephone nursor or aulhorized otflcor: (a0p) 366-261 4
l+tzne lrr.,,i.;li,lilffi.ffiltero,,his,omShldv Area Code ol ReDorlino Carrler
6/tB/20LB
Personswiltfullymaklngtal6ostatamontsonth16tormcanbspunl8hedbyrineortorfel{ureunderthsCommunlcallonsAclo,I1934,47U,S,C.0S502,
503(b), drflne or imprisorment underTlile 18 otlhe Unlted Stalss Code,18 U.S.C. $ 100'1.
TO BE COMPLETEO BY AN OFFICER OF THE REPORTING GARRIER
Certlflcation of Of{icer for Rate-of.Return Carrier Not Scoking Duplicative Rocovery
I certify that I am an officer of the reporting catJier and th.t, to the best of my knowledge, thls repo'tlng carrier i$ not 5eeklng duplicative r€cov€ry ln
the state r{risdlction ror any Elitible Recovery subject to the recovery mechanlsm as per 51.917(dxvli}.
Namo or Rooorrirro c,,,,", Ru ra I Telephg.rle po m paly - ld aho
05/30/18
ritle or position o, aulhoriTerl onicor ViCg-Pfgsident
rolephone number of aulhorlzed otfi'er: (20,8) -366-,?614
l+tzzss fr.,i,;.rlg7.3y;31,erorthis'ormStudv Area Code of R€oortino carrier
6/ t.8/ 20tB
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Persons wlllfully making false statemonli on this fotm can bo punlshcd by llne or forfsitute under tho Communlcaalons Acl of 1934, 47 U.S.C. 0$ 502,
503(b), orfine ot lmprlsonment irnder Tlllo 18 ollhe United Statos Code, 18 U,E,C.9'100,l.