20210202CenturyLink CenturyTel Gem State Form 555.pdf

',i. i:.ir,'Ei.f-'!I:l':. :I-i r'#:J
.:.. :?*, *'j E*i B:51J.,-; i ;J L
{K CenturyLink'
Jennifer G. Somers
Director, State Legislative Affairs
250 E 200 S. Suite '1000
Salt Lake City, UT 84111
801-209-0639
[e-mail]
February I,2021
Via Email
se c re taryt@pu c. idah o. g ov
Ms. Jan Noriyuki, Secretary
Idaho Public Utilities Commission 47 2
West Washington Street
P.O. Box 83720
Boise, Idaho 837 20-007 4
Docket No. GNR-T-21-I
2020 Lifeline 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-certifu 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 the Gem State 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 frling 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 filing.
Sincerely,
Jennifer
Attachment
In the Matter of Lifeline and Link Up Reform and Modernization, 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
Plcd 12947 (2013).
RE
Annual Lifeline Eligible Telecommunications Carrier Certification f,'orm 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: January 31't (Annually)
Does the reporting company have afliliated ETCs? Yes Eil No E[
Provide a list of all ETCI 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) ofthe Communications Act. That Section de/ines "afliliate" as "a person that (directly or indirectly)
owns or controls, is owned or controlled by, or is under common ownership or control wilh, another person." 47 U.S.C. S 153(2). See also 47
c..F.n..{ 76.1200.
Affiliated ETC's SAC Affiliated ETC's Name
1
472223 143002667
Study Area Code (SAC) Service Provider Identification Number (SPDQ
(An Etigibte Telecommunications Carrier @TC) must provide a certificationformfor each SAC through which it provides Lifeline service).
2020 ID CenturyLink CenturyTelof the Gem State (Nevat
Recertification Year
N/A
State ETCName
CenturyLink
DBA, Marketing, or Other Branding Name
(If sane as ETC rame, list "N/A" Do rct leave blank)
Holding CompanyName
(If same as ETC name, list "N/A" Do not leave blan*)
ETCs Subject to the Non-Usage Requirements
All ETCs must cotnplete the appropiate 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 nuiber ofsubscibers de-enrolled by month ii
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 Eil tto E[
If yes, 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
Julv 0
August 0
Septernber 0
October 0
November 0
December 0
Total Subscribers 0
For purposes of this filing, an offrcer 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, freasurer, or a comparable position. If the frler is a sole proprietorship, the owner must sign the certification.
Initial Certificatiort Att ETCs nust comptete this section
I certiff 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 anilor 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 Recertilication
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 monthB. Subscribers de-enrolled prior to recertification attemptsC. Total number of subscribers ETC is responsible for recertiffing (A-B)
Recertilication Methods
State of federal databaseD. Subscribers recertifiod through ETC access to state or federal database by anniversary month
the subscribers verified access to a state or federal database.
E. Name of the data source(s) used to verifu consumer eligibility:
ETC Direct ContactF. Subscribers contacted by ETC directly to recertifu (You may also use this section to report subscriber initiated recertifications).
the number oflifeline subscribers the ETC
G. Subscribers who failed to recertiff through ETC direct outreach attempt
the number ofLifeline subscribers de-enrolled due
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 Jul Aug sep Oct Nov Dec Year
Total
Jan Feb Mar
0 0 0 0 0 0 0 0 0D.0 0 0 0
Year
Total
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec
0 0 0 0 0F00000000
Jan Feb Mar Apr May Jun Jul Aug sep Oct 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
recertified
Third Party
I. Subscribers whose eligibility was reviewed by state administrator, third party administrator, or USAC
the number of Lifeline subscribers contacted a state thnd or USAC for the of recertificatim.
J. Name of third party administrator used to veri$, subscriber eligibility:
K. Subscribers de-enrolled as a result of a third party recertification attempt
the number ofsubscnlbers as a result or to outreach from a state thtud administrator or USAC
L. Subscribers who recertified through a state administrator, third party administrator, or USAC's recertification eflort
the number ofsubscribers that recertified z from a state thid or USAC
Certification:
Recertilication Method: Database
I certiff that the company listed above has procedures in place to recertiff consumer eligibility by relying on a database. I
am an oflicer of the company named above. I am authorized to make this certification for the SAC(s) listed above.
Initial
4
Oct Nov Dec Year
Total
Jan Feb Mar Apr May Jun Jul Aug sep
0 0 0 0 0 0 0H.0 0 0 0 0 0
Dec Year
Totel
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov
I.0 0 0 0 0 0 0 0 0 0 0 0 0
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov I)ec Year
Total
K.0 0 0 0 0 0 0 0 0 0 0 0 0
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
L.0 0 0 0 0 0 0 0 0 0 0 0 0
M:(c+K)N = (D+F+I)O =M/N*lfi)
Total number of subscribers de-enrolled as
a result of recertification
Total number of subscribers ETC is
responsible for recertifying
Percent of subscribers due for
recertification who were de-enrolled
0 0 0.0%
Recertification Method: ETC
I certifu that the company listed above has procedures in place to recerti$ the continued eligibility of all of its Lifeline
subscribers, and that, to the best of my knowledge, the company obtained sigrred certifications from all subscribers attesting
to their continuing eligibility for Lifeline. I am an offrcer of the company named above. I am authorized to make this
certification for the SAC(s) listed above.
Initial
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 certiff that my company did not claim federal low income support for any Lifeline subscribers for the current Form 555
datayear.I am an officer of the company named above. I am authorized to make this certification for the SAC listed
above.
1ni1id EJM
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,
Eric J. Mortensen SVP and Conholler Eric J. Mortensen SVP and Cont
Signature of Officer
[e-mail]
Email Address of Officer
Tucker Hickey
Person Completing This Certification Form
Printed Name and Title of Offrcer
Jan 27,2021
Date
720-387-3244
Contact Phone Number
5
SAC Name
472225 Centurylink CenturyTel of ldaho lnc.
475103 CenturvLink Qwest Corporation
475162 CenturvLink Qwest Corporation
Affiliated ETCs
6