20180720Gold Star Communications Form 481.pdf

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COMMUNICATIONS
Enclosures
$?ECE IVED
?Bl$ JUL 20 AH B: S0
July L7,2Ot8
Sincerely,
Michelle Motzkus
Legal & Regulatory Administrator
ph:307-883-6690
email : mamotzkus@silverstar. net
Diane Hanian, Secretary
ldaho Public Utilities Commission
472W. Washington
PO Box 83720
Boise, lD 83720-0074
Re 2018 Elieible Telecommunications Carrier (ETC)Annual Report Filing (Program
year 2019); Docket No. GNR-T-18-01
Gold Star Communications, LLC (479011)
Dear Ms. Hanian:
Gold Star Communications, LLC ("the Company") hereby files with the Commission its
2018 ETC Annual Report Filing (program year 20L91, as follows:
A copy of the FCC Form 481 - Carrier Annual Reporting Collection Form filed with the
Universal Service Administrative Company ("USAC"), completed pursuant to 47 CFR SS
54.422, along with the Officer Affidavit per Commission Order 2984L.
The Company has transitioned its customers to an MVNO model, with the last group of
customers scheduled to be transitioned by August 1. As such, Gold Star seeks only lifeline-only
recertification for the 2019 program year.
The Company respectfully requests that the Commission notify USAC and the FCC prior
to October 7,20L8 of its eligibility as a lifeline provider in order to continue participating in
available universal support programs for the year 2019.
Questions regarding this filing should be directed to my attention as shown below.
SilverStar.com PO Box 226,Freedorn, WY 83120 877.883.2411
State of Wyoming ) CERTIFICATION BY ELIGIBLE TELECOMMUNICATIONS CARRIER
: ss. OF COMPLIANCE WITH SERVICE QUALITY AND CUSTOMER
County of Lincoln ) PROTECTION, ABILITY TO REMAIN FUNCTIONAL lN
EMERGENCIES, AND USE OF FEDERAL HIGH-COST SUPPORT.
AFFIDAVIT OF BUS]NESS OR CORPORATE OFFICER
The ldaho Public Utilities Commission Order No. 29841. requires that Eligible Telecommunications Carriers
(ETC) certify that it is compliant with applicable service quality standards and consumer protection rules; and
ETCs must demonstrate the ability to remain functional in emergencies. ln addition, the Commission must file
an annualcertification with the USAC and the FCCthat allfederal high-cost support provided to ETCs within
the State of ldaho will be used only for the provision, maintenance, and upgrading of facilities and services for
which the support is intended. Accordingly, the undersigned states and verifies under oath the following:
1. I am an officer of Gold Star Communications, LLC (dba Silver Star Communications) an eligible
telecommunications carrier receiving federal universal service support under section 2Lakl of the
Telecommunications Act of 1996 in the state of ldaho.
2. I am familiar with the Company's day-to-day operations in the state of ldaho and with the State's service
quality standards and consumer protection rules as set forth in Commission Order No. 29841.
3. Gold Star Communications, LLC is complying with applicable service quality standards and consumer
protection rules of the Federal Communications Commission and the ldaho Public Utilities Commission
4. I certify to the Commission that the Company is able to remain functional in emergencies as set forth in
Commission Order No. 29841and in 47 C.F.R. 5 5a.201(aX2).
5. I also certify that all federal universal service support funds received by Gold Star Communications, LLC
during the current calendar year will be used in a manner consistent with section 25a!l; that is, for the
provision, maintenance, and upgrading of facilities and services for which the support is intended. The
company will continue to comply for the period of January 'J.,2019, through December 31, 2019, to be
eligible for federal universal service fund support.
6. This verification and affidavit is provided to be the ldaho Public Utilities Commission to enable the IPUC to
certify to the FCC that federal universal service support received by the eligible carriers in the state will be
used in a manner consistent with Section 254(e) of the Telecommunications Act.
Jefferson H.nd, C
Date
SUBSCRIBED AND SWORN to before me this -ll-ii., of July, 2018.
ry Public foBONNIE L. JACKSONState cf vVyoming-lJctary Public
CountY cf i-ir'(1Ci;'i
v
S
M Expires
2021
Commissiol
e tember 30
N
Commission expi
residing at Lincoln County
Page 1
<010> Study Area Code 4 ? 9011-
<015> Study Area Name GoId Star Comunications LLC
<020> Program Year 20t9
<030> Contact Name: Person USAC should contact
with questions about this data Michelle l{otzkus
<035> Contact Telephone Number:
Number ot the person identitied in data line <030>
3078836690 ext
<039> Contact Email Address:
Email of the person identified in data line <030>mamotzkusG silvers taE . net
Form Type 54 .422
Page 1
FCC Fo,m 481
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voice complaints (zero or greater) for voice telephony service in the prior
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any facilities you own, operate, lease, or otherwise utilize.
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Pree 13
<010> Study Area Code 47901 1
<015> Study Area Name GoId Star Communications LLC
<020> Pro8ram Year 20t9
<030> Contacl Name - Person USAC should contact regarding this data Michelle Motzkus
<035> ContactTelephoneNumber-Numberofpersonidentifiedandataline<030> 3078836690 ext.
<039> contact Email Address - Email Address of person identlfied in data line <030>mamotzkusG silverstar. net
Select from the drop down menu or check the boxes below to note compliance with 54.313(fX1). Privately held carriers must ensure compliance with the
financial reportingrequirementssetforthin4TCFR54.3l3(f)(2). lfurthercertifythattheinformationreportedonthisformandinthedocuments
attached below is accurate.
Progress Report on 5 Year Plan
Carrier certifies to 54.313(fXl)(iii)(300e)
(3010A)
(30108)
(3012A)
(30128)
(3013)
(3014)
(3015)
(3016)
(3017)
(3018)
(301s)
(3020)
(302U
Certification of Public lnterest Obligations {47 CFR 5
s4.313(f)(1xi))
Please Provide Attachment
Community Anchor lnstitutions {47 CFR 5
s4.313(f)(l)(ii))
Please Provide Attachment
ls your company a Privately Held RoR Carrier {47 cFR
I s4.313(fX2))
lf yes, does your company file the RUs annual report
Please check these boxes to confirm that the
attached PDF, on line 3017, contains the required
information pursuant to 5 54.313(fX2) compliance
requires:
Electronic copy of their annual RUS reports
(Operating Report for Telecommunications
Borrowers)
Document(s) with Balance Sheet, lncome Statement
and statement of Cash Flows
lf the response is yes on line 3014, attach your
company's RUS annual report and all required
documentation
lf the response is no on line 3014, is your company
audited?
lf the response is yes on line 3018, please check the
boxes below to confirm your submission on line
3026 pursuant to 5 54.313(0(2), contains:
Either a copy of their audited financial statement; or
(2) a financial report in a format comparable to RUs
Operating Report for Telecommunications Borrowers
Document(s) for Balance Sheet, lncome statement
and Statement of Cash Flows
lvlanagement letter and/or audit opinion issued by
the independent certified public accountant that
performed the company's financial audit.
lf the response is no oo line 3018, please check the
boxes below to confirm your submission on line
3026 pursuant to 5 54.313(f)(2), contains:
Copy of their financial statement which has been
subject to review by an independent certified public
accountanU 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
Name of Attached Document Listing Required
lnformation
Name of Attached Document Listing Required
lnformation
(Yes/No)
(Yes/No)
oooo
Name of Attached Document Listing Required
lnformation
(Yes/No)oo
(3022)
(3023)
(3024)Underlying information subjected to an officer
certification.
{302s)Document(s) with Balance Sheet, lncome Statement
and Statement ofCash Flows
E
E
E
II
(3026) Attach the worksheet listing required information Name of Attached Document Listing Required
lnformation
PrSe 13
(3m5, iat. Ol km C.rlcr Adduoel [e-mail]
Dita Col,ediff Fom
fCC Fom 461
OMB Contrcl t{o. 3060{985/OMB Cotrot t{o. :to6tN}819
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Page 15
<O1O> qtu.lv Ara, an.lp a-eo. I
<015> StudyArea Name :olr ita: coir.r:.ari.ns L::
<O2o> Prnerem YPar ,o:e
<O3O> Cont..t Nare - P"
<039> Contact Email Address - Email Address of person identified in data line <030> n.*:z:jre3,rv..5rar.n.:
4005 Rural Broadband Experiment
Authorized Rural Broadband Experiment (RgE) recipients must address the certification for public interest obligations and provide a
list of newly serued community anchor institutions.
Public lnterest Obligations - FCC 14-98 (paragrapht 25-29, 78)
PleaseaddressLine400lregardingcompliancewiththeCommission'spublicinterestobligations. AllRBEparticipantsmustprovidea
response to Line 4001.
4001. Recipient certifies that it is offering broadband meeting the requisite public interest obligations consistent with the category for
which they were selected, including broadband speed, latency, usage capacity, and rates that are reasonably comparable to rates for
comparable offerings in urban areas.
Community Anchor lnstitutions - FCC 1,4-98 (paragraph 79)
4003a. RBE participants must provide the number, names, and addresses of community anchor institutions to
whichtheynewlydeployedbroadbandseruiceintheprecedinBcalendaryear. Onthisline,pleaserespond
(yes - attach new community anchors, no - no new anchors) to indicate whether this list will be provided.
lf yes to 4003A, please provide a response for 40038.
4003b. Provide the number, names and addresses
of community anchor institutions to which the
recipient newly began providing access to
broadband seruice in the preceding calendar year.
Name of Attached Document Listing Required lnformation
Page 15
419011<Oln> str!.lv Area C^da
<015> Study Area Name Gold jt.. c,mor!:.tirn' !!c
Pa8e 15
<O?n> P.nrram V6er '.rq<o3D contact Name - peE6ililElf,6llZioiEa -g.ro-Gtt'it d"ta *"*"*,.
<039> contact Email Address - Email Address of person identified in data line <030> mderzk!5lsiryelsE.!.n.r
5005 Alaska Plan
(5010) Do you participate in the Alaska plan?(Yes/No)
(s011)
Please indicate whether any terrestrial backhaul or other satellite backhaul became
commercially available in the previous calendar year in areas previously served
exclusively by performance-limiting satellite backhaul.
(Yes/No)
(s012)
lf the filing carrier identified in its approved perfomance plans that it relies exclusively on
satellite backhaul for a certain poriton of the population in its service area, indicate whether
any terrestrial backhaul or other satellite backhaul became commercially available in the
previoius calendar year in areas that were previoiusly serued exclusively by satellite backhaul.
(Yes/No)
<5013>
D.s.ilption Of B.ckhaul T.chrolofl iewly S€ded Eilons or PopulationO.t! Baclhaul Av.ilable
PaSe 15
(flXlsl ALrka Phn Parti(h.nts Additi@l D@rentetion FCC fom 481
Data Collect of, Fom OMBCqrrd I{o. :l{l5G@86/OMB Cmrrol tao. :Ir6GO8l9
Julv 2018
Page 17
<010> Study Area Code 47901r
<015> Study Area Name GoLd Star Comunicati.ons llc
<020> Program Year 20L9
<030> Contact Name - Person USAC should contact regarding this data Michelle Motzkus
<035> Contact Telephone Number - Number of person identified in data line <030> 30?8836590 ext
<039> ContactEmailAddress-EmailAddressofpersonidentifiedindataline<030> namotzkusGsi.Iverscar.nec
TO BE COMPIETED BY THE REPORTING CARRIER, IF THE REPORTING CARRIER IS FILING ANNUAL REPORTING ON ITS OWN BEHALF:
Certification of Officer as to the Accuracy of the Data Reported for the Annual Reporting for CAF or Ll Recipients
I certify that I am an officer of the reportint carrier; my responsibilities include ensuring the accuracy of the annual reportint requirements for universal seruice support
recipients; and, to the best of my knowledge, the information reported on this form and !n any attachments is accurate.
NameofReportinsCarrier: 6o1d star comunicatj'ons Lr'c
SignatureofAuthorizedofficer: cERTrlrED ONLTNE Date o7 / 12/2org
printed name ofAuthorized officer: Jefferson England
Title or position ofAuthorized Officer: CFo
Ielephone numberof Authorized officer' 30?8836675 ext
Studv Area Code of Reoorting Carrier: 4?901 1 Filinc Due Oate for this totm. 01 / 15/2018
Persons willfully making false statements on this form can be punished by fne or forfeiture under the Communications Act of 1934, 47 U.5.C. 96 502, 503(b), or fne or imprisonment
underTitle 18 ofthe United States Code, 18 U.S.C. I 1001.
Page 17
OMB Control No. 3060{!,86/OMB Control No. 3060{819
FCC Form /l8l
Page 18
FCC Fom 481
OM8 Contd Nq.Data Collection Form
- Atent / Carrier
2018
479011<010> Study Area Code
<015> StudyArea Name Gold Star Comunications LLc
<020> Program Year 20L9
<030> Contact Name - Person USAC should contact regarding this data MicheIle Mctzkus
<035>contactTelephoneNumber-Numberofpersonidentifiedindataline<o3o> 3078836690 e*t'
<039> Contact Email Address - Email Address of person identified in data line <O3o> mamo E z ku s 0 s i lve r s ta r ' ne E
TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING ANNUAL REPORTS ON THE CARRIER'S BEHALF:
TO BE COMPLETED BY THE AUTHORIZED AGENT:
certification of Officer to Authorize an Agent to File Annual Reports for CAF or Ll Recipients on Behalf of Reporting carrier
I csrtify that (Name of is authorizod to submit the information roported on behalf of the reporting carrier, I
agent; and, to tho bost of my knowledgo, the roports and data provided to the authorizsd agsnt is accurate,
Name of Authorized Agent:
Name of Reponing Carrier:
iisnature of Authorized Officer:Date:
Printed name of Authorized Officer:
title or position ofAuthorized Officer:
Ielephone number of Authorized Offlcer:
;tudv Area Code of Reoortins Carrier:FalinS 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 $5 502, 503(b), or fne o. imprisonment
underritle 18 ofthe United States Code, 18 U.5.C. I 1001.
Certification o, Agent Authorized to File Annual Reports for CAF or U Recipients on Behalf of Reporting Carrier
the data reported herein based on data provided by the reportirg rarrier; and, to the best of my knowledge, the information reported herein is accurate.
Name of Reporting Carrier:
Name of Authorized AEent Firm:
SiEnature ofAuthorized Asent or Emolovee ofAgent:Date:
Name of Authorized Aeent Emplovee:
Title or position ofAuthorized Agent or Employee of Agent
Telephone number of Authorized Agent or Employee of Agent:
Study Area Code of Reporting Carrier: Filing Due Date for this form:
Page 18
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Gold Star Communications, LLC
dba Silver Star Communications ("Silver Star'')
SAC 479011- ldaho
Low-tncome Telephone Assistance Program Terms & Conditions
Statement of Compliance
(FCC Form 481 - Line 1210)
Silver Star provides unlimited local calling for lifeline-eligible residential
customers, discounted by the federally authorized amount of 59.25, and
state telephone assistance discounts, where applicable. Silver Star's
lifeline-discounted monthly telephone service provides access to
e mergency, operato r, interexcha nge, a n d d i rectory assista n ce services.
The service does not include enhanced calling features such as voice
mail, caller lD, call forwarding, internet or long distance telephone
service. foll Limitation service is provided at no charge for lifeline
customers, upon customer request and pursuant to FCC guidelines.