20190207Cingular Wireless Form 555.pdf

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John D. Sisemore
AT&T Services, Inc.
162 Roseheart
T:210-545-3519
F:214-202-5076
AT&T
[e-mail]
San Antonio, TX 78259
ilig f[E -7 Pt{ 2r 00
Wa Email
February 7,2019
Ms. Diane Hanian
Commission Secretary
Idaho Public Utilities Commission
472W. Washington
Boise,lD 83720-0074
secretar)r(g)puc. idaho. gov
Re: FCC Form 555. Annual Lifeline Elisible Telecommunications Carrier Certification
Form for New Cinsular Wireless PCS. LLC ("AT&T Mobilitv")
(Docket GNR-T-19-01)
Dear Ms. Hanian:
As required by the FCC in its February 6,2012 Released Order in WC Docket No. 11-42,
attached is a copy of AT&T Mobility's Idaho FCC Form 555 filed with the FCC.t 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,e )t- -, S-.^--
John Sisemore
Director - Regulatory
cc:Daniel Klein, ID PUC Daniel. Klein(@puc. idaho. qov
Margaret Thomson, Esq.
Attachment
I 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 Form 555, the online tool automatically populates a name associated with that
SAC. In some 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
IMPORTANIT: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 3k (Annually)
Does the reporting company have afliliated ETCs? Yes E[ No E
Provide a list of all ETCs that are afiliated with the reporting ETC, using page 4 and additional sheets if necessary. Afiliation shall be
determined in accordance with Section 3(2) of the Communications AcL That Section defines "afrliate" 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 1 53(2). See also 47
c.r.R. $ 76.1200.
Affiliated ETC's SAC Affiliated ETC's Name
1
479006 143029765
Study Area Code (SAC) Service Provider Identification Number (SPIN)
(An Eligible Telecommunications Canier (ETC) must provide a certificationformfor each SAC through which it provides Lifeline senice).
2018 lD Cingular Wireless
Recertification Year
N/A
State ETC Name
New Cingluar Wireless PCS, LLC
DBA, Marketing, or Other Branding Name
(lf same as ETC name, list "N/A" Do not leave blank)
Holding CompanyName
(lf same as ETC name, list "N/A" Do not leave blank)
ETCs Subject to the Non-Usage Requirements
All ETCs must complete the appropriate check-box. ETCs that do not assess and collect a nonthlyfeefrom 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 afee but do not collect suchfees 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 En No E[
If yes, record the number of subscribers de-enrolledfor non-usage by month in Block Q below.
P o
Month Subscribers De-Enrolled for Non-Usage
January 0
February 0
March 0
April 0
May 0
June 0
July 0
August 0
Septanber 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 sigrr the certification.
Initial Certificatiort Atl ETCs nust complete this seaion
I certifu 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; andlor
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 authorized to make this certification for the Study Area Code listed
above.
ALInitial
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 AL
Annual Recertification
Do not leave empty blocks. Ifan ETC has nothing to report in a block, enter a zero.
Report the number oflifeline 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 sourc{s) used to veril} consumer eligibility:
ETC Direct ContactF. Subscribers contacted by ETC directly to recertifu (You may also use this section to r€port subscriber initiated recertifications).
the number of Lifeline subscribers the ETC contacted to obtain recertifi cation
G. Subscribers who failed to recertifo through ETC direct outreach attempt
the number of Lifeline subscribers de-enrolled due to or to the ETC's outreach
3
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
A.2 0 1 2 0 0 0 0 0 0 0 1 6
B.0 0 0 0 0 0 0 0 0 0 0 0 0
c.2 0 1 2 0 0 0 0 0 0 0 1 6
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
D.0 0 0 0 0 0 0 0 0 0 0 0 0
Jan Feb Mar Apr May Jun sep DecJulAugOctNov Year
Total
F 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
G.0 0 0 0 0 0 0 0 0 0 0 0 0
H. Subscribers who recertified through ETC direct outreach attempt
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 thtd or USAC for the of recertification .
J. Name of third party administrator used to veriry subscriber eligibility:
USAC
K. Subscribers de-enrolled as a result ofa third party recertification attempt
the number of subscribers as a result or to outreach from a state administrator,thild 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 or USAC
Certification:
Recertification Method: Database
I certiff that the company listed above has procedures in place to recertifu consumer eligibility by relying on a database. I
am an offlcer of the company named above. I am authorized to make this certification for the SAC(s) listed above.
Initial
4
Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
Jan Feb Mar
0 0 0 0 0 0 0 0 0 0H.0 0 0
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year
Total
I.2 0 1 2 0 0 0 0 0 0 0 1 6
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
Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
Jan Feb Mar
L.2 0 1 2 0 0 0 0 0 0 0 1 6
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 authorizedto make this
certification for the SAC(s) listed above.
Recertification Method: Third Party
I certiff that the company listed above has procedures in place to recerti$ 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 AL
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.
Sigrred,
Anisa Latif, Director
Signature of Officer
[e-mail]
Email Address of Officer
Anisa Latif
Person Completing This Certification Form
Anisa Latif, Director
Printed Name and Title of Officer
Feb 06, 2019
Date
202457-3068
Contact Phone Number
M = (c+K)N = (D+F+I)o = M/1.{*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
recertilication who were ds.enrolled
0 6 0.0o/o
5
Initial
Affiliated ETCs
SAC Name
209012 Cingular Wireless
259908 Cingular Wireless
269905 Cingular Wireless
279010 Cingular Wireless
289912 Cingular Wireless
31 9026 Cingular Wireless
38901 5 ATandT Mobility LLC
39901 5 Cinqular Wireless
409004 ATandT Mobility LLC
449022 Cingular Wireless
529910 Cingular Wireless
619004 Cinqular Wireless
639005 Cingular Wireless
z'.t5191 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
295185 BellSouth Telecommunications LLC
305'150 The Ohio BellTelephone Company
31 5090 Michigan Bell Telephone Company
325080 lndiana Bell Telephone Company lncorporated
335220 Wisconsin Bell lnc
345070 lllinois Bell Telephone Company
405211 Southwestern Bell Telephone Company
415214 Southwestern Bell Telephone Company
5551 73 Nevada Bell Telephone Company
il5170 Pacific Bell Telephone Company
549004 ATandT Corp.
53901 0 ATandT Mobility LLC
445216 Southwestern Bell Telephone Company
6