20200121Rural Telephone Company.pdf

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RURAL TELECOM
RTI-
ssz w. Macrson av." .,J*EQSL!1F9".,
ldaho PUC
11331 W Chinden Blvd
Building 8 Ste 201-A
Boise lD 83714
)anuary 20,2020
Dear ldaho PUC:
Filing copy of FCC 555 form for informational purpose. Our Counties include
Elmore, Lemhi and Owyhee.
Sincerely,
,:$20 JAI'I 2l Al'l 91 32
' - *ri):i.:,,iissl0ll
dr*"J,u-
Theresa Wilson
Theresa Wllson I Billing Coordinator
RTI Telephone Company
892 W. Madison Avenue
Glenns Ferry lD 83623
Phone: [phone] | Far 208.356.2615.
E-mall: !hsc!e.JriE9-B@I&!.9Is
Web: gg!4l!ql!et!
Annurl Llfellne Ellglble Telecommunic.tions Carrier Certificstion Form All carriers must complete all or podions
of all sections Form musl be submitted to USAC and filed with the Fcdenl Communications Commission
IMPORTANT: PLEASE READ INSTRUCTIONS FIRST
Deodhne: January ila (Annually)
Does the reporfng company have aff,llated ETCs? Yes EE No E[
Proide a lht of dll EfCt thq, arc $iliord with lhe lqolrlng BIC '/,s,,g pag 4 md dd.litloldl shets ifnecesary. ,lfillallot shall be
dclemlned tn qcrwdonce ' iU, Seclion 3Q) ofthe Comduniutions Act. That Secdot tLfrnc, "afliliote" ar "d perroq lhal kltr"a t or hdttec y)
owas or cotlrols, is owned or.etnolled by, or h unda carnan own*shlp or cotrol with, onort.r pe$on," 47 U.S.C. $ 153(2). See also 47
c-Fk i 76.1200.
Affiliated ETC's SAC Afftliated ETC's Name
472233
Study Area Code (SAC) Servic€ Provider ldentification Number (SPIN)
(tbt Bligible Teleannunica,lont Carttet @rc) ,,l,ta, poide a cqltfcdtbr.fonalor c,,ch SAC lhmugl vhldt It proyides Lfel a setrlcc),
2019 ID Rural Telephone Company
Recertifrcation Year
N/A
Stato ETC Name
RURAL TELEPHONE COMPANY
DBA, Markoting or Other Brmrding Name
(Iftone ds Erc narne, lhl "N/rl" Do no, l.aye blarl,t)
Holding Company Name(f ww as EIt aans lkt "M1" Do nol leaw blaaq
1
143002523
ETCs Sublect to the Non-Urrye Requir€Nnetrts
lll EICs awt complele lhe apprcpriate chec*.box. EIer fiot do not alnetn arrd @lleot d otohrhlyf.efron th.D l$ellnc rrfiscribas are wbJecl
,o lhe noi-us.l,ge rqllrsi.rru. ET& Eubject to the non-woge r€qtlreQranlt ,lutl indicalc the duaba o! nbscriboz dc-anmlld by monrh ln
Setion l. EIl.,! lhqt oaly o*esr afe+ btt do not alha suchtea oe tubJql to E non4tage rcquhE rra,rb ond ,{/ust aho indlcate lhe autrbcr of
suMbcn de-earolld by trcnth.
fu the ETC rubJcct to the noFlregc requlrementr? Yes E[ No EE
lf|r.t, rcanl thc nunbcr ol subsctlber* de-@Tolled lor noq-ustge by donth h Block Q below.
P 0
Month Subscribers De-Enrolled for Non-Usage
Ianuary 0
February 0
March 0
Apnl 0
May 0
June 0
July 0
August 0
September 0
C)ctober 0
November 0
December 0
Total Subscribers 0
For purposes of this filing an offioer is an occupant of a position listed in the article of incorporation, orticles of forrratiorL
or other similar legal document An officer is a person who occupies a position specilied in the corporate byJaws (or
parhrership agreemenl), and would typically be presidenl vice president for operations, vice pesident for financq
comptrollcr, heasurer, or a comparable position. If the filer is a sole proprietorship, thc owner must sign the certification.
Initid Certilicatl oa. I Ercr ttun coiptd. fir, '.ctbn
I corti$ that the company listed above has certification pmccdures in place to:
A) Review income and program-based eligibility ilooumentation prior to enrolling a consumer in the Lifeline program, and
that, to the best of my knowledgr, the oompany \{as prerentod with doctmenbtion of each consurner's household
inoome and/or ptogram-based eligibility prior !o his or her enrollment in Lifeline; and/or
B) Confirm consumer eligibility by rolying upon access to a state databosc ld/or notice of oligibility from tho state
Lifeline admioistotor prior to enrolling a corsumor in the Lifeline program
I am ar officer ofthe company named above. I am authorized to nrake tl s oertification for the Study Area Code listed
abovo.
MJMInidal
2
Mlnimum Service Level
iliff * *. **any listed above is in compliaace with the minimum service levels set forth in the 47 CFR Section
I am an officer ofthe company named above. I am authorized to nrake this certification for the SACx listed above.
rnifisl MJM
AnnusI Recertiflcation
Do no, l.ae. @tpty blod6. Il dn ETC has nothing to rupoti in a blo*, eaw o zcro.
Report th€ nmbc( oflifElitrc arbfi.iber8 duo for lrccrtificatiotr by mo h (Janurry-Deccrobcr)A. Sutocriben cligiblc for rEoertificstion by oaoivcreary mouttB, Subscritem dc-cnrollcd prior to rw€dificstiou EttcopbC. Total mdq of qrbrcrib.rs BTC ir lspoosiblc ftr r€c€ i&ing (A-B)
Recertlllcation Methodc
Strte of fErler8l dstrbu€D, Subs8ib{r rcce.rtificd through Erc rcccas to shtc or foddal &t8basc by anniversary uronlh
tho rumbcr of rubscribcn verificd ao@!s !o a slslc or frdaael.r'r"hda
B, Naut6 ofths drta rourcds) urcd to vcriry coneumor cligibility:
ETC Dlroat ConarctF. Subscribere cootactcd by Erc diredly to rcceni& (You oay abo uso thir scctiotr to r.Eort subsctibcr initirlcd Ec€rti8carioos).
the numbcr of Ufellne rubsffibers tho EI C cootact d to ohtain rEcortificrtion of
G. Subsqtibcrs v/to frilcd to recerti$ lhrough ETC dirrct .u&cs.h Etlempt
th6 numbq oflifeliEt subscribers dGenrollcd du6 to to tb6 tjfc's outrcach
3
JrD tr'eb Mar Apr M"y Jun Jul Aug sep 0cf Nov Dec Yccr
Totrl
0 0 0 0 0 0 0 0 0 0 0 0 0
B 0 0 0 0 0 0 0 0 0 0 0 0
C.0 0 0 0 0 0 0 0 0 0 0 0 0
Jstr Feh Mar Apr Mry Jun Jul AUE sep Oct Nov Dec Ycar
Tot l
0D.0 0 0 0 0 0 0 0 0 0 0 0
Jan Feb Mar APr May Jutr Jul .Lug scp Oct Nov Dec Ycar
Toad
F 0 0 0 0 0 0 0 0 0 0 0 0 0
J!D Feb Apr Mry Jdn Jul Aw se,Ocr Nov llec Yerr
Totsl
G.0 0 0 0 0 0 0 0 0 0 0 0 0
0
Mrr
H. SubscriberD vifio ,€acdi6cd throuch BTC diEat outreach atctr4rt
tt DumbEr oflifrlinc 5ub$riber6 that rE{cnitrcd ETC', outE ch
Thlrd PrrtyI. Sukcribcrs nirocc eligibiitywrs rwicwcdby stotc adnrinistrrtot, third porty adrddstrator, or USAC
lic nu*er of Lif.lioe sublcrib€n c@hctcd drird sdmhilt3tor or USAC for th€of Eq.tillcaticr,
J. NrE€ ofthird pafy adaitris&.tor ured to verif arbsoriber cligibility
National verifler
K. Suhrqibcr8 de-€drolled as a rrsult of a &id party recqrtification dtdnpt
lhc numba of gubscribcn !l r r6lult of to or.drqch trom o n e third or USAC.
L. Subscriberr wto recenifi€d thrcugh a ststo adefuistrator, thiJd psrty admiuistator, or USAC'8 r€certifcstioo effort
tho lumbcr of subscrib€rs thal r6ceni6cd Aool s ibt. rdminirhslor, 6ird adEirirhBtor or USAC
Jatr Feb Nov Dc.Yesr
Told
L 2 0 0 0 0 2 0 0 2 1 0 0 7
Certificallon:
Recerdff csff on Method: I)atebars
I certifu that the compeny listed above hss procedures in place to rscertiry consurner eligibility by relying on a database. I
am an officer ofthe company named above. I am authorized to make this certification for the SAC(S) list€d above.
Inidal
4
M.y Jun Jul Aug Nov D€a Yeir
Total
JaE Feb APr sep Oc(
H.0 0 0 0 0 000000
Mry Jtrn Nov DecFobM.r APr Jul Aug sep Oca Yerr
Totrl
I.2 0 0 0 0 2 0 0 2 1 0 0 7
Jan Feb M.r AP.Mry Jun Jul Ary sep Oct Nov Dec Yerr
Totsl
K 0 0 0 0 0 0 0 0 0 0 0 0 0
M.r
0 0
Jrtr
I'-TE-T'" f'" l-Ti.c|* J-
Recer{fl cafl on Method: ETC
I certifr that the company listed above has procedurcs in placo to recerti-& the continued eligibility of all of its Lifeline
subscribers, and that, to the best ofmy knowledge, the company obtained signed certifications fiom all zubscribers attesting
to theit continuing eligibility for Lifeline. I am an ofticer of the company named above. I am authorized to make this
certification fm the SAC(s) listed abovo.
lnltial
Recertificrtion Method: Third Perty
I certi$ that the cornpany listed above has proccdures in place to recertifr consumer eligibility by relying on an
administsator. I arn an officer ofthe company named above. I sm authodz€d to Dake this certification for the SAC(s)
listed above.
1664 MJM
No Sttbscdbers
I ccrti$ that my compsny did not oleim federal low income suppofi for any Lifeline zubscribqs for the oun€nt Form 555
data year. I am an ollicer of the company named above. I am authorized to make this certilisation for the SAC ljsted
abovc.
Iniflal
M - ((;+K)N E (D+F+I)o - M/Nr100
Totrl nrubcr ofrubrcrlbcrr de-cnrtll€d es
. r..ult of rc.ertlllc.tlotr
Totrl trumber of subrcrlbers ETC t
rc.poDrlble for reertifyiDg
PsrceDt of rubscr'ibera due for
recerdf,cadotr {ho lYcrt d}elrolled
0 7 o.oYo
Signature Block
By signing beloq I cerlifl tlat the company listed above is in compliance with all federal Lifelinc certification
procedures. I am an officer ofthe company named abovo. I am authorized to make this cfftification for tle Study
Area Code (SAC) listed above.
Signed,
Micbael J Martell
SigDsure ofOfficor
[e-mail]
Email Ad&css of Officcr
Theresa Wilson
Ponon Coopleiog'I'hfu Ccrtific.tion Form
Michael J Martell
Prfutcd NsEr and Tiflc of oltrcer
Jan 17,2020
Date
2083662614
ConlEct PhonE Numbcr
5
Affiliated ETCs
SAC Name
6
-