20210202CenturyLink CenturyTel Form 555.pdf

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Jennifer G. Somers
Director, State Legislative Affairs
250 E 200 S. Suite 1000
Salt Lake City, UT 84111
801-209-0639
[e-mail]
February 1,2021
Via Email
s e c r e t ary@1r u c. i d a h o. g o v
Ms. Jan Noriyuki, Secretary
Idaho Public Utilities Commission 47 2
West Washington Steet
P.O. Box 83720
Boise, Idaho 83720-007 4
Docket No. GNR-T-21-1
2020 Lifetine re-certification results reported to the FCC and USAC
Dear Ms. Noriyuki:
Pursuant to the Federal Communications Commission's Report and Ordert requiring eligible
telecommunications carriers to re-certiff the eligibility of their Lifeline subscribers and to report the
results to the Federal Communications Commission, Universal Service Administrative Company and to
state commission and Tribal governments, CenturyTel of Idaho hereby submits its2020 Lifeline re-
certification results for the state of Idaho.
Please note that the results are provided separately for each FCC study area. In addition, the numbers
being reported this year are mostly zero as we are no longer handling the verifications and
recertifications. The Lifeline National Eligibility Verifier (National Verifier) has taken over these
functions for all states except the Opt-out-states of Oregon and Texas. Per USAC's instructions, we are
still completing and filing the Form 555 reports; only we are filling them in with zeros where the
National Verifier has taken over.
Please do not hesitate to contact me at (801)-209-0639 or via e-mail at iennifer.somers(@lumen.com
should you have any questions regarding this frling.
Sincerely,
Jennifer
Attachment
In the Matter of Lifeline and Link Up Reform and Modemization, Lifeline and Link Up, Federal-State Joint Board on
Universal Service, Advancing Broadband Availability Through Digital Literacy Training, Report and Order and Further
Notice of Rulemaking,2T FCC Rcd 6656, 6715-161132 (2012);47 C.F.R. $ 54.416. Also see Public Notice, 28 FCC
Frcd 12947 (2013).
RE
Annual Lifeline Etigible 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 31r. (Annually)
Does the reporting company have affiliated ETCs? Yes Eil 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 wilh Section 3(2) of the Communications Act. That Section de/ines "afiliale" as "a person that (directly or indirectly)
owns ot 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 S 76.1200.
Affiliated ETC's SAC Affiliated ETC's Name
L
472225 143002517
Study Area Code (SAC) Service Provider Identification Number (SPIN)
(An Eligible Telecommunications Carrier @TC) must provide a certificationformfor each SAC through which it provides Lifeline semice).
2020 lD CenturyLink CenturyTelof ldaho lnc.
Recertification Year
N/A
State ETCName
CenturyLink lnc.
DBA, Marketing, or Other Branding Name
(If same as ETC name, list "N/A" Do ry11lene bhnk)
Holding CompanyName
(If sane as ETC name, list "N/A" Do not leatte blank)
ETCs Subject to the Non-Usage Requirements
All ETCs must complete the appropriate check-box. ETCs that do not assess and collect a monthlyfeefrom their Lifeline subscribers are subject
to the non-usage requirernmts. ETCs subject to the non-usage requirements must indicate the nurnber 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 nurnber of
subscribers de-enrolled by month.
Is the ETC subject to the non-usage requirements? yes Eil No E[
Ifyes, record the number of subscribers de-enrolled for non-usage by month in Block Q below.
P o
Month Subscribers De-Enrolled for Non-Usase
January 0
February 0
March 0
April 0
May 0
June 0
July 0
Auzust 0
Septernber 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 byJaws (or
partnership agreement), and would typically be president, vice president for operations, vice president for finance,
comptroller, heasurer, or a comparable position. If the filer is a sole proprietorship, the owner must sign the certification.
Initial Certificatiott All ETCs nust complete this section
I certifr 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 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.
EJMInitial
2
Annual Recertification
Do not leave empty blocks. Ifan 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 month
B. Subscribers de-enrolled prior to recertification attemptsC. Total number of subscribers ETC is responsible for recerti$ing (A-B)
Recertification Methods
State of federal databaseD. Subscribers recertified through ETC access to state or federal database by anniversary month
the number subscribers verified access to a state or federal database.
E. Name of the data source(s) used to veriry consumer eligibility:
ETC Direct ContactF. Subscribers contacted by ETC directly to recertiff (You may also use this section to report subscriber initiated recertifications).
the number oflifeline subscribers the ETC contacted to obtain recertification of
G. Subscribers who failed to recertifu through ETC direct outreach attempt
the number of Lifeline subscribers de-eorolled due to or to the ETC's outreach
3
Jan Feb Mar Apr May Jun Jut Aug sep Oct Nov Dec Year
Total
A.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 0
c.0 0 0 0 0 0 0 0 0 0 0 0 0
Apr May Jun JUIJanFebMar 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 Jul Aug sep Oct Nov Dec 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 0ct Nov Dec Year
Totel
G.0 0 0 0 0 0 0 0 0 0 0 0 0
H. Subscribers who recertified through ETC direct outreach attempt
Lifeline subscribers that recertified ETC's outeach
Third Party
I. Subscribers whose eligibility was reviewed by state administrator, third party administrator, or USAC
the number ofLifeline subscribers contacted a state thild administrator oTUSAC forthe ofrecertification.
J. Name of third party administrator used to verifr subscriber eligibility:
K. Subscribers de-enrolled as a result ofa third party recertification attempt
the number ofsubscribers as a result of or to outeach ftom a stat€lhftd oTUSAC
L. Subscribers who recertified through a state administrator, third party administrator, or USAC's recertification efTort
the number ofsubscribers that recertified a from a state thtud administrator oTUSAC
Certification:
Recertification Method: Database
I certiff 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
May Jun Jul Aug sep Oct Nov Dec Year
Total
Jan Feb Mar Apr
0 0 0 0 0 0 0 0 0H.0 0 0 0
May Jun sep Oct Nov Dec Year
Totrl
Jan Feb Mar Apr Jut Aug
L 0 0 0 0 0 0 0 0 0 0 0 0 0
Nov Dec Year
Totrl
Jan Feb Mar Apr May Jun Jul Aug sep Oct
K.0 0 0 0 0 0 0 0 0 0 0 0 0
Dec Year
Totrl
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov
L.0 0 0 0 0 0 0 0 0 0 0 0 0
Recertilication Method: ETC
I certify that the company listed above has procedures in place to recertiff 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 oflicer of the company named above. I am authoriznd to make this
certification for the SAC(s) listed above.
Initial
Recertification Method: Third ParE
I certiff that the company listed above has procedures in place to recertify consumer eligibility by relying on an
administrator. I am an offrcer of the company named above. I am authorized to make this certification for the SAC(s)
listed above.
Initial
No Subscribers
I certiff that my company did not claim federal low income support for any Lifeline subscribers for the current Form 555
data year. I am an offrcer of the company named above. I am authorized to make this certification for the SAC listed
above.
166a1 EJM
Signature Block
By signing below, I certiff 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,
Eric J. Mortensen SVP and Controller Eric J. Mortensen SVP and Cont
Signature of Officer
eric.mortensen men.com
Printed Name and Title of Officer
Jan 27,202'l
Email Address of Officer
Tucker Hickey
Person Cornplaing This Certification Form
Date
720-387-3243
Contact Phone Number
M:(G+K)N = (D+F+I)O = M/N*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
recertification who were de-enrolled
0 0 0.0o/o
5
AffiIiated ETCs
SAC Name
472223 Centurvlink CenturvTel of the Gem State (Nevada)
475103 CenturvLink Qwest Corooration
475162 CenturyLink Qwest Conporation
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