20190201TracFone Wireless Form 555.pdf

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wireless, inc.
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January 31,2019 Sr,^.lf- r- tg-o I
VIA OVERNIGHT MAIL
Jean Jewell, Secretary
Idaho Public Utilities Commission
472W. Washington St.
Boise, lD 83720
Re: TracFone Wireless, Inc. - FCC Form 555 Report
Dear Ms. Jewell:
In accordance with the Federal Communication Commission's Lifeline Reform Order
and 47 CFR 54.416(b) please find enclosed a copy of the FCC Form 555 Report of TracFone
Wireless Inc. ("TracFone"). You may reach me at [phone] if you have any questions.
--
Stephen Athanson
Regulatory Counsel
R:C E IVI D
www.tracfone.com lwww.netl0.com lwww.straighttalk.com lwww.safelink.com
Sincerely,
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: Jonuary 31st (Annually)
Does the reporting company have affiliated ETCs? Yes Eil No @
Provide a list of all ETCs that are affiliated with the reporting ETC, using page 4 and addilional sheets if necessary. Affiliation shall be
determined in accordance with Section 3(2) of the Communications AcL That Section defines "afiliate" as "a person that (directly or indirectly)
owns or controls, is 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.F.R. $ 76.t200.
Affiliated ETC's SAC Affiliated ETC's Name
479021 143030103
Study Area Code (SAC) Service Provider Identification Number (SPIN)
(An Eligible Telecommunications Caruier (ETC) must provide a certificationform for eoch SAC through which it provides Lifeline semice).
2018 ID TracFone Wireless lnc
Recertification Year
SafeLink Wireless
State ETC Name
TracFone Wireless lnc
DBA, Marketing, or Other Branding Name
(lf same as ETC name, list "N/A" Do rnt leave blank)
Holding Company Name
(If same as ETC tnme, list "N/A" Do not leave blank)
1
ETCs Subject to the Non-Usage Requirements
All ETCs must complete the appropriate check-box. ETCs that do not assess and collect a monthly fee from their Lifeline subscribers are subject
to the non-usage requirements. ETCs subject to the non-usage requirements must indicate the number of subscribers de-enrolled by month in
Section 4. ETCs that only assess a fee but do not collect such fees are subject to the non-usage requirements and must also indicate the number of
subscribers de-enrolled by month.
Is the ETC subject to the non-usage requirements? ' yes @ No E[
Ifyes, record the number ofsubscribers de-enrolledfor non-usage by month in Block Q below.
P o
Month Subscribers De-Enrolled for Non-Usage
January 17
February 16
March 16
April 18
May 12
June 5
July 12
August 12
September 16
October 12
November 20
Decembei 24
Total Subscribers 180
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 Certificatiort All ETCs must comptete this 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 andlornotice 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 authorized to make this certification for the Study Area Code listed
above.
JRInitial
2
Minimum Service Level
I certifu that the company listed above is in compliance with the minimum service levels set forth in the 47 CFR Section
s4.40{.
I am an officer of the company named above. I am authorized to make this certification for the SACs listed above.
Initial JR
Annual Recertification
Do not leave empty bloclts. 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 attemptsC. Total number of subscribers ETC is responsible for recertifuing (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 verifu ccnsumer eligibility:
ETC Direct ContactF. Subscribers contacted by ETC directly to recertify (You may also use this section to report subscriber initiated recertifications).
the number of Lifeline subscribers the ETC contacted to obtain
G. Subscribers who failed to recertify through ETC direct outreach aftempt
the number of Lifeline subscribers de-enrolled due to or
3
Jan Feb Mar Apr May .Iun Jul Aug sep Oct Nov Dec Year
Total
A.24 33 18 21 30 23 23 31 14 15 16 283
B.6 7 3 5 11 3 4 5 6 1 2 2 55
C.18 26 15 16 19 20 19 30 25 13 13 14 228
Jan Feb Mar Apr May Jun Jul Aug Sep 0ct Nov Dec Year
Total
D.0 0 0 0 0 0 0 0 0 0 0 0 0
Jan AprFebMar May Jun Jul Aug Sep Oct Nov Dec Year
Total
F 18 26 15 16 19 20 19 30 25 13 13 14 228
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year
Total
G.12 20 8 12 3 5 7 9 5 3 6 6 96
35
H. Subscribers who recertified through ETC direct outreach attempt
the number 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 ol recertification
J. Name of third party administrator used to verifu subscriber eligibility:
K. Subscribers de-enrolled as a result ofa third party recertification attempt
the number of subscribers as a result of inel or to outreach fiom a state administrator.third 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 third adm or USAC
Certification
Recertification Method: Database
I certifo that the company listed above has procedures in place to recertify 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
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
H.6 6 7 4 16 15 12 21 20 10 7 8 132
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
I.0 0 0 0 00000 0
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
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 0
0 0 0
0
M = (G+K)N : (D+F+l)o: M/N*100
Total number ofsubscribers de-enrolled as
a result of recertilication
Total number of subscribers ETC is
responsible for recertifo ing
Percent ofsubscribers due for
recertifi cation who were de-enrolled
96 228 42.11o/o
Recertification Method: ETC
I certify that the company listed above has procedures in place to recertify 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 JR
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.
Initial
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,
Javier Rosado - Sr.Business I Javier Rosado - Sr. Officer, Busi
Signature of Officer
[e-mail]
Email Address of Officer
Janet Morejon
Person Completing This Certification Form
Printed Name and Title of Officer
Jan 29,2019
Date
305-715-6522
Contact Phone Number
5
Affiliated ETCs
SAC Name
5