20210624i-wireless Form 481 and Affidavit.pdf

Page 1
Page 1
FCC Form 481 - Carrier Annual Reporting FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name: Person USAC should contact
<035>Contact Telephone Number:
<039>Contact Email Address:
Data Collection Form
Form Type 54.422
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 2
Page 2
(200) Service Outage Reporting (Voice)
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<220>
NORS
Reference
Number
Outage Start
Date
Outage Start
Time
Outage End
Date
Outage End
Time
Number of
Customers Affected Total Number of
911 Facilities Service Outage Affect Multiple
Service Outage Preventative
<210>For the prior calendar year, were there any reportable voice service outages?
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line
<030>
<039>Contact Email Address - Email Address of person identified in data line
<030>
<400>
Select from the drop-down list to indicate how you would like to report
voice complaints (zero or greater) for voice telephony service in the prior
calendar year for each service area in which you are designated an ETC for
any facilities you own, operate, lease, or otherwise utilize.
<410>Complaints per 1000 customers for fixed voice
<420> Complaints per 1000 customers for mobile voice
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Page 3
(400) Number of Complaints per 1,000 customers
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
(500) Compliance With Service Quality Standards and Consumer Protection Rules
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
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Page 4
<515> Certify compliance with applicable minimum service standards
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
<010>
<015>
<020>
<030>
<035>
<039>
Study Area Code
Study Area Name
Program Year
Contact Name - Person USAC should contact regarding this data
Contact Telephone Number - Number of person identified in data line <030>
Contact Email Address - Email Address of person identified in data line <030>
(600) Functionality in Emergency Situations
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<600> Certify compliance regarding ability to function in emergency situations
Page 5
<610> Descriptive document for Functionality in Emergency Situations
Page 5
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 6
Page 6
(800) Operating Companies
Data Collection Form
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<810>Reporting Carrier
<811>
<812>
<813>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
<813>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
<813>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
<813>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
Not Applicable
Sam Bailey
Not Applicable
2022
[e-mail]
i-wireless, LLC
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 7
<910>Tribal Land(s) on which ETC Serves
<920>Tribal Government Engagement Obligation
<921>
<922>
<923>
<924>
<925>
<926>
<927>
<928>
<929>
(900) Tribal Lands Reporting
Data Collection Form
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
Page 7
<900>Does the filing entity offer tribal land services? (Y/N)
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 8
(1000) Voice and Broadband Service Rate Comparability
Data Collection Form
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<1000> Voice services rate comparability certification
<1010> Attach detailed description for voice services rate
comparability compliance
Name of Attached Document
comparability compliance
Name of Attached Document
Page 8
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 9
Page 9
(1100) No Terrestrial Backhaul Reporting
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<1130>
Certify whether terrestrial backhaul options exist (Y/N)<1100>
<1140>Alaska Plan rate-of-return certification (yes, no, or not applicable) of
compliance with approved performance plan.
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 10
Page 10
(1200) Terms and Condition for Lifeline Customers
Lifeline
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819 December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<1210>Terms & Conditions of Voice Telephony Lifeline Plans
<1221>
<1222>
<1223>
<1220>Link to Public Website HTTP
telephony service plans offered to Lifeline subscribers,
Details on the number of minutes provided as part of the plan,
https://www.accesswireless.com/support/terms-and-conditions
Sam Bailey
2022
[e-mail]
IWI 1210 template_2021_ID_Tribal.pdf
I-Wireless, LLC dba Access Wireless
5135502755 ext.
4
4
4
479020
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Page 11
(2005) Price Cap Carrier Additional Documentation
Data Collection Form
Including Rate-of-Return Carriers affiliated with Price Cap Local Exchange Carriers
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<2015> 2016 and future Frozen Support Certification 47 CFR § 54.313(c)(4)
Select the appropriate responses below (Yes, No, Not Applicable) to note compliance as a recipient of frozen High Cost support, High Cost support
to offset access charge reductions, and Connect America Phase II support as set forth in 47 CFR 54.313(c),(d),(e). The information reported on this
form and in the documents attached below is accurate.
Price Cap Carrier Connect America ICC Support {47 CFR § 54.313(d)}
<2016> Certification support used to build broadband
Connect America Phase II Reporting {47 CFR § 54.313(e )}
<2017A> Connect America Fund Phase II recipient?
<2017C> Total amount of Phase II support, if any, the price cap carrier used for
capital expenditures in 2018.
<2018> Attach the number, names, and addresses of community anchor
institutions to which the carrier newly began providing access to
broadband service in the preceding calendar year - 54.313(e)(1)(ii)(A)
Name of Attached Document Listing
Required Information
Connect America Phase II – FCC Form 470 Postings
For the filing due July 1 following full implementation of this requirement,
answer yes, no, or not applicable to this certification request
<2019>
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 12
(3005) Rate Of Return Carrier Additional Documentation
Data Collection Form
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
Page 12
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
(3007)
Name of Consultant Name of Consultant Firm/Third Party
(3007a) (3007b)
Does this filing retain a Cost Consultant and/or Firm, or other Third Party to prepare financial and
operations data disclosures submitted to the National Exchange Carrier Association (NECA), USAC,
or the Administrator?
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
Select from the drop down menu or check the boxes below to note compliance with 54.313(f)(1). Privately held carriers must ensure compliance with the
financial reporting requirements set forth in 47 CFR 54.313(f)(2). I further certify that the information reported on this form and in the documents
attached below is accurate.
Progress Report on 5 Year Plan (3009) Carrier certifies to 54.313(f)(1)(iii)
(3010A)
(3010B)
(3012A)
(3012B)
Name of Attached Document Listing Required
Information
(3013) (Yes/No)
(3014) (Yes/No)
(3015)
(3016)
(3017) Name of Attached Document Listing Required
Information
(3018) (Yes/No)
(3019)
(3020)
(3021)
(3022)
(3023)
(3024)
(3025)
(3026) Name of Attached Document Listing Required
Information
(3005) Rate Of Return Carrier Additional Documentation
Data Collection Form
Page 13
Certification of Public Interest Obligations {47 CFR §
54.313(f)(1)(i)}
Please Provide Attachment
Rate-of-Return Community Anchor Institutions
Indicate if the carrier newly deployed broadband
service to community anchor institution(s) in the
previous calendar year.
Please Provide Attachment
Using link, download template and list the number,
name and address for each community anchor
institution. Attach the document which contains the
community anchor institution details as required by
47 C.F.R. § 54.313(f)(1)(ii)
Is your company a Privately Held ROR Carrier {47
CFR § 54.313(f)(2)}
If yes, does your company file the RUS annual report
Please check these boxes to confirm that the
attached PDF, on line 3017, contains the required
information pursuant to § 54.313(f)(2) compliance
requires:
Electronic copy of their annual RUS reports
(Operating Report for Telecommunications
Borrowers)
Document(s) with Balance Sheet, Income Statement
and Statement of Cash Flows
If the response is yes on line 3014, attach your
company's RUS annual report and all required
documentation
If the response is no on line 3014, is your company
audited?
If the response is yes on line 3018, please check the
boxes below to confirm your submission on line
3026 pursuant to § 54.313(f)(2), contains:
Either a copy of their audited financial statement; or
(2)a financial report in a format comparable to RUS
Operating Report for Telecommunications Borrowers
Document(s) for Balance Sheet, Income Statement
and Statement of Cash Flows
Management letter and/or audit opinion issued by
the independent certified public accountant that
performed the company’s financial audit.
If the response is no on line 3018, please check the
boxes below to confirm your submission on line
3026 pursuant to § 54.313(f)(2), contains:
Copy of their financial statement which has been
subject to review by an independent certified public
accountant; or 2) a financial report in a format
comparable to RUS Operating Report for
Telecommunications Borrowers
Underlying information subjected to a review by an
independent certified public accountant
Underlying information subjected to an officer
certification.
Document(s) with Balance Sheet, Income Statement
and Statement of Cash Flows
Attach the worksheet listing required information
Page 13
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
Name of Attached Document Listing Required Information
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 14
(3005) Rate Of Return Carrier Additional Documentation (Continued)
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
Name of Attached Document Listing Required Information
Financial Data Summary
(3027) Revenue
(3028) Operating Expenses
(3029) Net Income
(3030) Telephone Plant In Service(TPIS)
(3031) Total Assets
(3032) Total Debt
(3033) Total Equity
(3034) Dividends
Page 14
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
4005 Rural Broadband Experiment
Authorized Rural Broadband Experiment (RBE) recipients must address the certification for public interest
obligations and provide a list of newly served community anchor institutions.
Public Interest Obligations – FCC 14-98 (paragraphs 26-29, 78)
Please address Line 4001 regarding compliance with the Commission’s public interest obligations. All RBE
participants must provide a response to Line 4001.
4001. Recipient certifies that it is offering broadband meeting the requisite public interest obligations consistent
with the category for which they were selected, including broadband speed, latency, usage capacity, and rates that
are reasonably comparable to rates for comparable offerings in urban areas.
RBE Community Anchor Institutions
<4003a> Indicate if the carrier newly deployed broadband service to community anchor institution(s) in the
previous calendar year
<4003b> Please Provide Attachment: Using link,
download template and list the number, name
and address for each community anchor
institution. Attach the document which contains
the community anchor institution details as
required by FCC 14-98 (paragraph 79)
Name of Attached Document Listing Required Information
(4005) Rural Broadband Experiment Additional Documentation
Data Collection Form
Page 15
Page 15
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 16
(5005) Alaska Plan Participants Additional Documentation
Data Collection Form
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
5005 Alaska Plan
(5011)(Yes/No)
(5012)
Please indicate whether any terrestrial backhaul or other satellite backhaul became
commercially available in the previous calendar year in areas previously served
exclusively by performance-limiting satellite backhaul.
If the filing carrier identified in its approved perfomance plans that it relies exclusively on
satellite backhaul for a certain poriton of the population in its service area, indicate whether
any terrestrial backhaul or other satellite backhaul became commercially available in the
previoius calendar year in areas that were previoiusly served exclusively by satellite backhaul.
(Yes/No)
Page 16
<5013><c>
Newly Served Locations or Population
<a>
Description Of Backhaul Technology
<b>
Date Backhaul Available
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 17
(6005) Phase II Auction Reporting
Data Collection Form
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<6010> Enter the total amount of Phase II Auction Support, if any, the carrier used
for capital expenditures
<6011>
Phase II Auction and New York Funds Certification
Certify (either yes or no) regarding whether the recipient has available
funds for all project costs that will exceed the amount of support that will
be received for the next calendar year. This certification must be provided
starting the first July 1st after receiving support until the recipient’s
penultimate year of support
(Yes/No)
Page 17
<6012a>
Phase II Auction Community Anchor Institutions
Indicate if the carrier newly deployed broadband service to community
anchor institution(s) in the previous calendar year
<6012b>Please Provide Attachment Using link, download template and list the
number, name and address for each community anchor institution.
Attach the document which contains the community anchor
institution details as required by FCC 14-98 (paragraph 79)
Phase II Auction FCC Form 470 Postings
<6013>For the filing due July 1 following full implementation of this
requirement answer yes or no to this certification request
Phase II Auction Post-Final Deployment Milestone Performance Certification
Starting the first July 1st after meeting the final service milestone, certify
(yes or no) that the Phase II-funded network that the Phase II auction
recipient operated in the prior year meets the relevant performance
requirements in § 54.309
<6014>
Name of Attached
Document Listing Required
Information
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 18
(7005) Phase-Down Support Reporting
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<7010>Phase II Auction recipient performance requirements certification (Yes/No)
Page 18
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 19
(8005) Uniedo a Puerto Rico Fixed and Mobile Funds Certification
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<8010>
<8011>
<8012b>
<8012a>
<8013>
<8014>
<8020>
<8030>
<8040>
<8050>
<8060>
Uniendo a Puerto Rico Stage 2 Fixed – Capital Expenditures
Enter the total amount of Uniendo a Puerto Rico Stage 2 fixed support, if any, the
carrier used for capital expenditures.
Uniendo a Puerto Rico Stage 2 Fixed – Available Funds Certification
Certify (either yes or no) regarding whether the recipient has available funds for all project costs that will exceed the amount of support that will be received for the next calendar year. This certification must be provided starting the first July 1st after receiving support until the recipient’s penultimate year of support.
Uniendo a Puerto Rico Stage 2 Fixed – Community Anchor Institutions
Indicate if the carrier newly deployed broadband service to community anchor institution(s)
in the previous calendar year.
Please Provide AttachmentUsing link, download template and list the number, name and address for each community anchor institution. Attach the document which contains the community anchor institution details as required by 47 C.F.R. § 54.313(e)(2)(A). Allowable File Types.
Uniendo a Puerto Rico Stage 2 Fixed – FCC Form 470 Postings
For the filing due July 1 following full implementation of this requirement answer yes, no, or
not applicable to this certification request.
Uniendo a Puerto Rico Stage 2 Fixed – Post-Final Deployment Milestone Performance Certification
Starting the first July 1st after meeting the final service milestone, certify (yes or no) that the Uniendo a Puerto Rico Stage 2-funded network that the Stage 2 recipient operated in the prior year meets the relevant performance requirements in § 54.309.
Uniendo a Puerto Rico Stage 2 Fixed – Support Reimbursement Certification
54.313(n): Recipients of Uniendo a Puerto Rico Fund Stage 2 fixed support shall certify that
such support was not used for costs that are (or will be) reimbursed by other sources of
support, including of federal or local government aid or insurance reimbursements; and that
support was not used for other purposes, such as the retirement of company debt unrelated
to eligible expenditures, or other expenses not directly related to network restoration,
hardening, and expansion consistent with the framework of the Uniendo a Puerto Rico Fund.
Uniendo a Puerto Rico Stage 2 Fixed – Disaster Preparedness and Response Documentation
54.313(n): Recipients of fixed support from Stage 2 of the Uniendo a Puerto Rico Fund shall certify that they have conducted an annual review of the documentation required by section 54.1515(a)-(c) to determine the need for and to implement changes or revisions to disaster preparation and recovery documentation.
Uniendo a Puerto Rico Stage 2 Mobile – Support Reimbursement
54.313(n): Recipients of Uniendo a Puerto Rico Fund Stage 2 mobile support shall certify that
such support was not used for costs that are (or will be) reimbursed by other sources of
support, including of federal or local government aid or insurance reimbursements; and that
support was not used for other purposes, such as the retirement of company debt unrelated
to eligible expenditures, or other expenses not directly related to network restoration,
hardening, and expansion consistent with the framework of the Uniendo a Puerto Rico Fund.
Uniendo a Puerto Rico Stage 2 Mobile – Disaster Preparedness and Response Documentation
54.313(n): Recipients of mobile support from Stage 2 of the Uniendo a Puerto Rico Fund shall
certify that they have conducted an annual review of the documentation required by section
54.1515(a)-(c) to determine the need for and to implement changes or revisions to disaster
preparation and recovery documentation
Uniendo a Puerto Rico Stage 2 Mobile – Mobile Disbursements Certification
54.313(o): Recipients of Uniendo a Puerto Rico Fund Stage 2 mobile support shall certify that they are in
compliance with all requirements for receipt of such support to continue receiving Stage 2 mobile
disbursements
Name of Attached
Document Listing Required
Information
Page 19
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 20
(9005) Connect USVI Fixed and Mobile Funds Certification
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
<9010>
<9011>
<9012b>
<9012a>
<9013>
<9014>
<9020>
<9030>
<9040>
<9050>
<9060>
Connect USVI Stage 2 Fixed – Capital Expenditures
Enter the total amount of Connect USVI Fund Stage 2 fixed support, if any, the carrier used for capital expenditures.
Connect USVI Stage 2 Fixed – Available Funds Certification
Certify (either yes or no) regarding whether the recipient has available funds for all project
costs that will exceed the amount of support that will be received for the next calendar year.
This certification must be provided starting the first July 1st after receiving support until the
recipient’s penultimate year of support.
Connect USVI Stage 2 Fixed – Community Anchor Institutions
Indicate if the carrier newly deployed broadband service to community anchor institution(s)
in the previous calendar year.
Please Provide Attachment
Using link, download template and list the number, name and address for each community
anchor institution. Attach the document which contains the community anchor institution
details as required by 47 C.F.R. § 54.313(e)(2)(i)(A).
Connect USVI Stage 2 Fixed – FCC Form 470 Postings
For the filing due July 1 following full implementation of this requirement answer yes, no, or
not applicable to this certification request.
Connect USVI Stage 2 Fixed – Post-Final Deployment Milestone Performance Certification
Starting the first July 1st after meeting the final service milestone, certify (yes or no) that the
Connect USVI Fund Stage 2-funded network that the Stage 2 recipient operated in the prior year
meets the relevant performance requirements in § 54.309.
Connect USVI Stage 2 Fixed – Support Reimbursement Certification
54.313(n): Recipients of Connect USVI Fund Stage 2 fixed support shall certify that such support was not used for costs that are (or will be) reimbursed by other sources of support, including of federal or local government aid or insurance reimbursements; and that support was not used for other purposes, such as the retirement of company debt unrelated to eligible expenditures, or other expenses not directly related to network restoration, hardening, and expansion consistent with the framework of the Connect USVI Fund.
Connect USVI Stage 2 Fixed – Disaster Preparedness and Response Documentation
54.313(n): Recipients of fixed support from Stage 2 of the Connect USVI Fund shall certify that they
have conducted an annual review of the documentation required by section 54.1515(a)-(c) to
determine the need for and to implement changes or revisions to disaster preparation and recovery
documentation.
Connect USVI Fund Stage 2 Mobile - Support Reimbursement Certification
54.313(n): Recipients of Connect USVI Fund Stage 2 mobile support shall certify that such support was not used for costs that are (or will be) reimbursed by other sources of support, including of federal or local government aid or insurance reimbursements; and that support was not used for other purposes, such as the retirement of company debt unrelated to eligible expenditures, or other expenses not directly related to network restoration, hardening, and expansion consistent with the framework of the Connect USVI Fund. Recipients of mobile support from Stage 2 of the Connect USVI Fund shall certify that they have conducted an annual review of the documentation required by section 54.1515(a)-(c) to determine the need for and to implement changes or revisions to disaster preparation and recovery documentation.
Connect USVI Fund Stage 2 Mobile - Disaster Preparedness and Response Documentation
54.313(n): Recipients of mobile support from Stage 2 of the Connect USVI Fund shall certify that
they have conducted an annual review of the documentation required by section 54.1515(a)-(c) to
determine the need for and to implement changes or revisions to disaster preparation and response
documentation.
Connect USVI Fund Stage 2 Mobile - Mobile Disbursements Certification
54.313(o): Recipients of Connect USVI Fund Stage 2 mobile support shall certify that they are in
compliance with all requirements for receipt of such support to continue receiving Stage 2 mobile
disbursements.
Name of Attached
Document Listing Required Information
Page 20
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 21
Page 21
Certification - Reporting Carrier
Data Collection Form
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819 December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
TO BE COMPLETED BY THE REPORTING CARRIER, IF THE REPORTING CARRIER IS FILING ANNUAL REPORTING ON ITS OWN BEHALF:
Printed name of Authorized Officer:
Certification of Officer as to the Accuracy of the Data Reported for the Annual Reporting for CAF or LI Recipients
Name of Reporting Carrier:
Signature of Authorized Officer:Date
I certify that I am an officer of the reporting carrier; my responsibilities include ensuring the accuracy of the annual reporting requirements for universal service support
recipients; and, to the best of my knowledge, the information reported on this form and in any attachments is accurate.
Title or position of Authorized Officer:
Telephone number of Authorized Officer:
Study Area Code of Reporting Carrier:Filing Due Date for this form:
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment under Title 18 of the United States Code, 18 U.S.C. § 1001.
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
5135502755 ext.
479020
Page 22
Page 22
Certification - Agent / Carrier
Data Collection Form FCC Form 481OMB Control No. 3060-0986/OMB Control No. 3060-0819 December 2020
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
Certification of Agent Authorized to File Annual Reports for CAF or LI Recipients on Behalf of Reporting Carrier
TO BE COMPLETED BY THE AUTHORIZED AGENT:
Telephone number of Authorized Agent or Employee of Agent:
Signature of Authorized Agent or Employee of Agent:
Name of Authorized Agent Firm:
I, as agent for the reporting carrier, certify that I am authorized to submit the annual reports for universal service support recipients on behalf of the reporting carrier; I have provided
the data reported herein based on data provided by the reporting carrier; and, to the best of my knowledge, the information reported herein is accurate.
Date:
Name of Authorized Agent Employee:
TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING ANNUAL REPORTS ON THE CARRIER'S BEHALF:
Certification of Officer to Authorize an Agent to File Annual Reports for CAF or LI Recipients on Behalf of Reporting Carrier
I certify that (Name of Agent)_______________________________________________________ is authorized to submit the information reported on behalf of the reporting carrier. I
also certify that I am an officer of the reporting carrier; my responsibilities include ensuring the accuracy of the annual data reporting requirements provided to the authorized
agent; and, to the best of my knowledge, the reports and data provided to the authorized agent is accurate.
Date:
Name of Authorized Agent:
Signature of Authorized Officer:
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment under Title 18 of the United States Code, 18 U.S.C. § 1001.
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment under Title
18 of the United States Code, 18 U.S.C. § 1001.
Sam Bailey
07/01/2021
2022
Regulatory Specialist
[e-mail]
8598028421 ext.
479020
7702329200 ext.
06/18/2021
479020
CFO
I-Wireless, LLC dba Access Wireless
Sean Cullen
5135502755 ext.
I-Wireless, LLC dba Access Wireless
06/17/2021
07/01/2021
CERTIFIED ONLINE
Maddy Roberts
Expert Telecom Compliance
Expert Telecom Compliance
Expert Telecom Compliance
CERTIFIED ONLINE
479020
I-Wireless, LLC dba Access Wireless
<010>Study Area Code
<015>Study Area Name
<020>Program Year
<030>Contact Name - Person USAC should contact regarding this data
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>
Certify Filing
Data Collection Form
Page 23
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
I certify under penalty of perjury that no universal service support has been or will be used to purchase,
obtain, maintain, improve, modify, or otherwise support any equipment or services produced or provided
by any company designated by the Federal Communications Commission as posing a national security
threat to the integrity of communications networks or the communications supply chain since the
effective date of the designations
Please Provide Waiver Document
Allowable File Type (pdf only)
Name of Attached Document Listing Required
Information
Page 23
Sam Bailey
2022
[e-mail]
I-Wireless, LLC dba Access Wireless
Yes
5135502755 ext.
479020
Attachments
Form 481 section 1210
(Effective June 29, 2020)
Voice Bundle 
grandfathered*Legacy Bundle**Broadband 
Bundle Tribal Plan
Voice Minutes  (non‐rollover) 1,250 1,250 500 Unlimited
Text Unlimited Unlimited Unlimited Unlimited
Data 50MB ‐ 500MB 3 GB 3 GB 4 GB
Additional Airtime
Free Data‐Capable Device   X     X  X   X  
Local Calls   X     X  X   X  
Nationwide Long Distance   X     X  X   X  
Voicemail, Caller ID, Call Waiting   X     X  X   X  
Free 911   X     X  X   X  
Free 611   X     X  X   X  
Balance Inquiries   X     X  X   X  
Text Included   X     X  X   X  
Data Allowance   X     X  X   X  
Participation in Kroger Wireless 
Rewards Program   X     X  X   X  
Retail Price  n/a   n/a n/a  n/a 
Federal Subsidy $5.25 $9.25 $9.25 $34.25
State Subsidy $3.50 $3.50 $3.50 $3.50
Lifeline Consumer Price $0 $0 $0 $0
*
**
ACCESS WIRELESS TOP UP CARDS***
Non‐Tribal
Purchased 
Minutes Text (SMS/MMS) Data
$5 Card 250 Unlimited 250 MB
$10 Card 500 Unlimited 500 MB
$25 Card Unlimited Unlimited 2 GB
$35 Card Unlimited Unlimited 3 GB
$50 Card Unlimited Unlimited 10 GB
Tribal
Purchased 
Minutes Text (SMS/MMS) Data
$5 Card Unlimited Unlimited 500 MB
$10 Card Unlimited Unlimited 1GB
$25 Card Unlimited Unlimited 7.5 GB
$35 Card Unlimited Unlimited 8.5 GB
$50 Card Unlimited Unlimited 10 GB
***Unlimited minutes and texts expire after 30 days from the date the funds were applied to the account; limited minute 
and data allotments do not expire.
i‐wireless, LLC's "Access Wireless" Lifeline Rate Plans 
Grandfathered for existing customers without a smartphone prior to 12/1/19
Available to existing customers with a smartphone prior to 12/1/19
Available with purchase of Top Up Card
Non‐Tribal