20210202Cingular Wireless Form 555.pdf

AT&T
Janice Ono
Area Manager - Regulatory
AT&T Services, Inc,
5250 S. virginia Street
Room 202
Reno, NV 89502
T: 775.333.3991
M:775.527.3365
Janice,ono@att,com
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February 1,2021
Ms. Jan Noriyuki
Commission Secretary
Idaho Public Utilities Commission
11331 W. Chinden Blvd.
Building 8, Suite 201-A
Boise,ID 83714
secretary@puc. idaho. gov
Re:FCC Form 555. Annual Lifeline Elisible Telecommunications Carrier Certification
Form for New Cingular Wireless PCS. LLC ("AT&T Mobilitv")
fl)ocket GNR-T-21-01)
Dear Ms. Noriyuki
On behalf of New Cingular Wireless PCS, LLC (dba'AT&T Mobility"), attached please find a
copy of FCC Form 555.t AT&TMobility is providing you with a copy of this FCC filing in
accordance with47 C.F.R. $5a.a22@). Receipt of this information requires NO action on your
part. It is strictly informational.
If you have any questions concerning this matter, please do not hesitate to call me to discuss. I
can be reached at775.333.3991.
Sincerely
Janice Ono
cc Daniel Klein, ID PUC [e-mail]
Carol Anderson, Esq.
Attachment
I AT&T Mobility filed its FCC Form 555 online with the Universal Service Administrative Company (USAC).
Once a carrier enters its six-digit study area code (SAC) into USAC's online FCC Form 555, the online tool
automatically populates a name associated wittr that SAC. In some cases, this automatically-generated name differs
from (e.g., is an abbreviated version of) the legal entity name for AT&T Mobility's eligible telecommunications
carrier affiliate.)
Annual Lifeline Eligibte 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
IMPORTANT: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 31't (Annually)
Does the reporting company have affiliated ETCs? Yes @ No Eil
Provide a list of all ETCs that are o.filiated with the reporting ETC, using page 4 and additional sheets if necessary. Afiliation shall be
determined in accordance with Section j(2) of the Communications Act. That Section defines "afiliate" as "a person that (directly or indirectly)
owns or controls, is ownd or controlled by, or is under common otnership or control with, another person." 47 U.S.C. S 153(2). See also 47
c.F.R. $ 76.1200.
Affiliated ETC's SAC Affiliated ETC's Name
1
479006 143029765
Study Area Code (SAC) Service Provider Identification Number (SPIN)
(An Eligible Telecommunications Carrier (ETC) must provide a certificationformfor each SAC through which it provides Lifeline sewice).
2020 lD Cingular \Mreless
Recertification Year
N/A
State ETC Name
New Cingluar Wireless PCS, LLC
DBA, Marketing, or Other BrandingName
(If same as ETC name, list "N/A" Do not leave blank)
Holding CompanyName
(If same as ETC name, list "N/A" Do not 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 requirements must indicate the number ofsubscribers 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
subscibers de-enrolled by month.
Is the ETC subject to the non-usage requirements? yes @ No Eil
Ifyes, record the number of subscribers de-enrolledfor 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
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 agreement), and would typically be president, vice president for operations, vice president for finance,
comptroller, treasurer, or a comparable position. If the filer is a sole proprietorship, the owner must sign the certification.
Initial Certilicatiort Alt ETCs nust complee this section
I certifu that the company listed above has certification procedures in place to:
A) Review income and program-based eligibility documentation priorto 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.
ALGInitial
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 priorto recertification affempts
C. Total number of subscribers ETC is responsible for recertifring (A-B)
Recertification Methods
State of federal databaseD. Subscribers recertified through ETC access to state or federal database by anniversary month
the number of subscribers
E. Name of the data source(s) used to verifu consumer eligibility:
ETC Direct ContactF. Subscribers contacted by ETC directly to recertifr (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 recertiff through ETC direct outreach attempt
the number of Lifeline subscribers de-enrolled due to or 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
sep 0ct Nov Dec Year
Total
Jan Feb Mar Apr May Jun Jul Aug
0 0 0 0D.0 0 0 0 0 0 0 0 0
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Year
Totel
F 0 0 0 0 0 0 0 0 0 0 0 0 0
Jen Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
0G.0 0 0 0 0 0 0 0 0 0 0 0
H. Subscribers who recertified through ETC direct outreach attempt
recertified ETC's outreach
Third Party
I. Subscribers whose eligibility was reviewed by state administrator, third party administrator, or USAC
the number oflifeline subscribers contacted a stat€thnd or USAC for the of recertification.
J. Name of third party adminishator used to verift subscriber eligibility:
K. Subscribers de-enrolled as a result ofa third party recertification attempt
the number ofsubscribers as a result of or to outreach from a state administrator third administrator orUSAC.
L. Subscribers who recertified through a state administrator, third party administrator, or USAC's recertification effort
the number ofsubscribers that recertified from a state administrator third administrator or USAC
of
a
Certification:
Recertification 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 officer of the company rurmed above. I am authorized to make this certification for the SAC(s) listed above.
Initial
4
Apr May Jun JulJanFebMar Aug sep 0ct Nov Dec Year
Total
0H.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
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 Dcc Year
Total
K.0 0 0 0 0 0 0 0 0 0 0 0 0
Jan Feb Mer Apr May Jun Jul Aug Sep Oct Nov Dec Year
Totrl
L.0 0 0 0 0 0 0 0 0 0 0 0 0
M=(G+K)N = (D+F+r)O = M/l{*100
Total number ofsubscribers de-enrolled as
e result of recertilication
Total number ofsubscribers ETC is
responsible for recertifying
Percent ofsubscribers due for
recertification who were de-enrolled
0 0 0.0%
Recertification Method: ETC
I certiff 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
Recertilication Method: Third Party
I certiff that the company listed above has procedures in place to recertiff 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.
1ai1i1g ALG
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,
Anisa Latif Director Anisa Latif Green, Director
Signature of Officer
[e-mail]
Email Address of O{Iicer
Anisa Latif Green
Person Completing This Certification Form
Printed Name and Title of Officer
Feb 01 2021
Date
202457-3068
Contact Phone Number
5
SAC Name
209012 Cinqular \Mreless
259908 Cinqular \Mreless
269905 Cinqular Wireless
279010 Cinoular Wireless
289912 Cinoular Wireless
31 9026 Cingular Wireless
38901 5 ATandT Mobilitv LLC
39901 5 Cinoular Wireless
409004 ATandT Mobilitv LLC
449022 Cinqular Wireless
52991 0 Cinqular Wireless
639005 Cinqular Wireless
2',15191 BellSouth Telecommunications LLC
225192 BellSouth Telecommunications LLC
235193 BellSouth Telecommunications LLC
245194 BellSouth Telecommunications LLC
255181 BellSouth Telecommunications LLC
26s182 BellSouth Telecommunications LLC
275183 BellSouth Telecommunications LLC
285184 BellSouth Telecommunications LLC
295185 BellSouth Telecommunications LLC
3051 50 The Ohio BellTelephone Company
315090 Michiqan Bell Telephone Company
325080 lndiana Bell Telephone Company lncorporated
335220 \Msconsin Belllnc.
345070 lllinois BellTelephone Companv LLC
405211 Southwestern Bell Teleohone Comoanv
415214 Southwestern Bell Telephone Company
555173 Nevada Bell Telephone Company
545170 Pacific Bell Telephone Company
549004 ATandT Coro.
53901 0 ATandT Mobility LLC
445216 Southwestern Bell Telephone Company
649006 Cinqular Wireless
Affiliated ETCs
6