20210202CenturyLink North Form 555.pdf

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{K CenturyLink'
Jennifer G. Somers
Director, State Legislative Affairs
25OE20O S. Suite 1000
Salt Lake City, UT 84111
801-209-0639
[e-mail]
February 1,2021
Via Email
s e c r e tary@1t u e i d a h o. g ov
Ms. Jan Noriyuki, Secretary
Idaho Public Utilities Commission 47 2
West Washington Steet
P.O. Box 83720
Boise, Idaho 837 20-007 4
Docket No. GNR-T-21-1
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, CenturyLink (Northern 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 jennifer.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, 6715-16fl132 (2012);47 C.F.R. $ 54.416. Also see Public Notice, 28 FCC
Frcd 12947 (2013).
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Annual Lifeline Eligible Telecommunications Carrier Certilication 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
IMPORTA]\T: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 31't (Annually)
Does the reporting company have affiliated ETCs? Yes EII No E[
Provide a list of all ETCs that are ffiliated with the reporting ETC, using page 4 and additional sheets if necessary. Afiliation shall be
determined in accordance with Section 3(2) ofthe Communicalions Act. Thal Section de/ines "afiiliate" as "a person lhat (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 l5i(2). See also 47
c.F.R. $ 76.r200.
Affiliated ETC's SAC Affiliated ETC's Name
L
475162 143005231
Study Area Code (SAC) Service Provider Identification Number (SPIN)
(An Eligible Telecommunications Carrier @TC) must provide a certificationfonnfor each SAC through which it proides Lifeline service).
2020 ID CenturyLink Qwest Corporation
Recertification Year
N/A
State ETCName
CenturyLink
DBA, Marketing, or Other Branding Name
(If same as ETC name, list "N/A" Do ry11leave bhnk)
Holding CompanyName
(If same as ETC rwmq list "N/A" Do rut 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 monthlyfeefrom their Lifeline subscribers are subject
to the non-usage requirements. ETCs subject to the non-usage requirernents 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 E[ No E[
Ifyes, 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
Mav 0
June 0
July 0
August 0
September 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 agreernent), and would typically be president, vice president for operations, vice president for finance,
comptroller, treasurer, or a comparable position. If the frler is a sole proprietorship, the owner must sign the certification.
Initial Certificatiott Alt ETCs nust comptete this section
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; and/or
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 offtcer 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 bloclcs. If an 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 priorto recertification attemptsC. Total number of subscribers ETC is responsible for recerti$ing (A-B)
Recertification Methods
State of federal databaseD. Subscribers recertified through ETC access to state or federal database by anniversary month
the number of verified access to a stat€ or federal database.
E. Name of the data source(s) used to veriff consumer eligibility:
ETC Direct ContactF. Subscribers contacted by ETC directly to recertifu (You may also use this section to report subscriber initiated recertifications).
the number oflifeline subscribers the ETC contacted of
G. Subscribers who failed to recertifu through ETC direct outreach attempt
subscribers de-enrolled due to the ETC's outreach
3
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year
Totel
A.0 0 0 0 0 0 0 0 0 0 0 0 0
B.0 0 0 0 0 0 0 0 0 0 0 0 0
C.0 0 0 0 0 0 0 0 0 0 0 0 0
Jan Feb Mrr Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
D 0 0 0 0 0 0 0 0 0 0 0 0 0
Sep Oct Nov Dec Year
Total
Mar Apr May Jun Jul AugJanFeb
0 0 0 0 0 0 0F.0 0 0 0 0 0
sep Oct Nov Dec Year
Total
Mar Apr May Jun Jul AugJanFeb
0 0 0 0 0 0 0G.0 0 0 0 0 0
H. Subscribers who recedified through ETC direct outreach attempt
the number oflifeline subscribers that recertified ETC's outreach
Third Party
I. Subscribers whose eligibility was reviewed by state adminishator, third party administrator, or USAC
the number ofLifeline subscribers contacted a state thtud oTUSAC forthe ofrecertification.
J. Name of third party administrator used to verifu subscriber eligibility:
K. Subscribers de-enrolled as a result of a third party recertification attempt
the number of subscribers as a result of or to outreach from a state administrator, third administ'ator, or USAC.
L. Subscribers who recertified through a state adminishator, third pafi administrator, or USAC's recertification effort
the number ofsubscribers that recertified a from a state administator, third oTUSAC
Certification:
Recertification Method: Database
I certi$ 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
Jan Feb Mar Apr May Jun Nov Dec Year
Totel
Jul Aug sep Oct
H.0 0 0 0 0 0 0 0 0 0 0 00
Jan Feb Mar Apr May Jun Jut Aug sep Oct Nov I)ec Year
Total
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 Dec 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 0ct Nov Dec Year
Total
L.0 0 0 0 0 0 0 0 0 0 0 0 0
Recertification Method: ETC
I certiS 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 officer of the company named above. I am authorized to make this
certification for the SAC(s) listed above.
Initial
Recertification Method: Third Party
I certi$ 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 certifr 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.
166x1 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.
Signed,
Eric J. Mortensen SVP and Controller Eric J. Mortensen SVP and Cont
Sigrature of Officer
[e-mail]
Email Address of Officer
Tucker Hickey
Person Cornpleting This Certification Form
Printed Name and Title of Officer
Jan 27,2021
Date
720-387-3246
Contact Phone Number
5
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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 deenrolled
0 0 0.0o/o
SAC Name
472225 CenturyLink CenturyTel of ldaho lnc.
472223 CenturyLink CenturyTel of the Gem State (Nevada)
475103 Centurvlink Qwest Corporation
Affiliated ETCs
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