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Home My WebLink About20190614Midvale Telephone CAF ICC.pdfI certlfy thal I am an offi6. ot tho cpo.tlng canler; my responrlblllllg. lnclude ensqring the acc!6cy of the actual data cportcd; and, to lhe beil ol my knwlodge, lhg ldom.tlon Bported or lhl! lom lr accuEte. Cortitlcatlon of Ofllcar as lo th€ Accuracy of the CAF ICC Oata Reported Name of Reporting Carrier:MIDVALE TEL. EXCH. INC. Digilally sign* by John Stuail DN:cn=John Sluad,emeil+hn.sluad@mle@m.@m,O=midvale tel. erch. inc.l:Midvale lD 83il5. D6b:5/282019 John Stuart Signature ol Authorized Ofiicer:Date: 512812019 Printed name of Authorized Officen John Stuart Title or position of Authorized Officer:CEO TelephonenumberofAuthorizedOfflcer: 208-355-2211 Study Area Code of Reporting Carrier 472226 Filing Due Date for this form (mmidd/yyyy)6t17t2019 PoEons wlllfully maklng lalse statqmonts on thls torm can bE punl6hed by fins or tortglture under the Communlcatlons Act ol 1934, 47 U.S.C. SS 502, 503(b), or llne or lmp,lsonment undor Tltle 10 of the Unlted States Code, 1E U,S,C. S ,t00't. TO BE COMPLETED BY THE REPORTING CARRIER,7- '9-o 7 f - !c=) \-o TEmC,511 #g UI -l - --i =.o(r'i+"'ci C)_.. :h(.3Tr U>C> 9,o, TO BE COMPLETED BY IHE REPORTING CARRIER, IF AN AGENT IS FILING DATA ON THE CARRIER'S BEHALF: Cartlflcatlon of Officer to Authorlze an Agent to File Data Reported on BGhalf ot Reporting Carrier - National Exchange Carriers Association, lnc. .I certity that (Name ofAg.nt) is authorized lo submit the intoJmation repoded on behalt orthe reporting carler. l.lso certify lhat I am an ofrier of the rcponing c.rrie.; my respomlbilltle! Include ensuring the .ccu6cy ofthc data provldod lo the Authorized Agcnt; and, to the b6t ol my knwoledge, the actual data provided to the Authorlzod Name of Authorized Agent National Exchange Carriers Association, lnc. Name of Reporting Carrier:MIDVALE TEL. EXCH. INC. John Stuart Signature of Authorized Officer: inc..l=Midvele lD 83645. Dab:51282o19 Date: 5l?812019 Printed name ol Authorized Officerl John Stuart Title or position of Authorized Officer:CEO Telephone number of authorized officer:208-355-2211 Study Area Code of Repoffng Carier 472226 Filing Due Date for this form (mm/dd/yyyy)6117t2019 PeBons wllltully making false statoments on thls form can be punished by flne or tgrtoiture undea the Communicatlons Act ot 1934, 47 U.S.C. 55 502, 503(b), or flne or lmprlsonment under Title l8 of tho Unlted States Code, 18 U.S.C. S 1 001. TO BE COMPLETED BY AN OFFICER OF THE REPORTING CARRIER Certification of Officer for Rate{t-Return Carrier Eligibilily for CAF/ICC Recovery I certlty thol I am an ot0@r of th. rcpo,llng carler and that, to the bcEt of my knowlcdge, thc .epoaling carrie, on thls lorm cenllle! that it har complled with Ellglble Recovery S5t.9t7(d) and Acce3r Recovery Charge 551.91?(e) and is eligible to reeive the CAF ICC aupport oqurltod puBu.nt lo S5l.9l7(0. Name of Reporting Carrier:MIDVALE TEL. EXCH. INC. John Stuart Siua(email=john.sluad@mte@m @m,O=midvale lel. erch. inc.,l=Midvale lO 8S45. Date:5/28/2019 Signature of Authorized Officer or employee:Date: 512812019 Printed name of Authorized Officer or employeo:John Stuart Title or position of Authorized Officer or employee:CEO Telephone number of Authorized Officer or employee:208-355-2211 Study Area Code of Reporting Catrier 472226 Filing Due Date for this form (mm/dd/yyyy)6t17t2019 PoBons wlllfully maklog lalsg statomonts on this lorm can be punished by fine or forfeiture undor the Communications Acl ot 1934, 47 U.S.C. SS 502, 503(b), or flne or lmp,lsonment under Tltle 1E of the United States Code, '18 U.S.C. S 1001. I TO BE COMPLETEO BY AN OFFICER OF THE REPORTING CARRIER Certiticatlon of Offlcer for Rated.Return Carrier Not Segklng Dupllcative Recovery I certity lhat I am an otlie. of the @porting carrie, and that, to lhe be3t of my knowledgc, thc ,eponlng cariler is not seeking duplicative reovery in the rtatc rurl.dlcllon for any Ellgible Recovery .ublect to the recovcry mechanlsm as per S51.917(dxvil). Name of Reporting Carrier:MIDVALE TEL. EXCH, INC, John Stuart Digilally signed by John Sluail DN:cn=John Stuad,email=lohn.stuart@mle@m.6m,O=midvale lel. exch. inc.,l=Midvale lD 83645. Dats:52&2019 Signature of Authorized Officer or employee:Date: 512812019 Printed name of Authorized Officer or employee:John Stuart Title or position of Authorized Officer or employee:CEO Telephone number of Authorized Officer or employee:208-355-2211 Study Area Code of Reporting Carrier 472226 Filing Due Date for this form (mm/dd/yyyy)6t17t2019 Person3 willtully maklng falso statemenls on ihls form can be punlshed by fino or fortolture undor the Communication3 Act ot 1934, 47 U.S.C. SS 502, 503{b}, or tlne o. lmprlsonment under Title l8 of the Unlted States Code, I 8 U.S.C. S 100i. Certification of Oflicer as to the Accuracy of the Data Reported for the Rate Floor Data I certify that I am an officer ot the reporting carier; my responsibilities include ensuring the accuracy ot the actual rate floor data reported and, to ths best of my knowledge, the inlormation reponed on this form is accurate. Name of Reporting Carrier:r D\,/A.L€.* ial.6e"*oN}B- Signature of Authorized Officer:Date: 6-a-$ Printed name of Authorized Officer:J*'*'.$i-r-,6:,rer Title or position of Authorized Officer -hersrD4^5.i* (€-* (*, Telephone number of Authorized Officer Zaf'^- 3s5-zz I t Study Area Code of Reporting Carrier 4'lzzzu Filing Due Date for this form (mm/dd/yyyy) 07t01t2019 I certify that our mmpany reeives or is projecled to receive High Cost Loop Support (or Frozen High Cost Support that is based on HCLS or High Cost Model Support) during the period July 2019 through June 2020, but has no monthly residentiat rates (ptus charges as detined) less than $18.00. x