20210628Gold Star Communications Form 481 Affidavit.pdf

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SENT VIA EMAIL: [e-mail]
Jan Noriyuki, Commission Secretary
ldaho Public Utilities Commission
11331W. Chinden Blvd. Bldg. 8, Ste. 201-A
Boise, ID 83714
2021 Eligible Telecommunications Carrier (ETCIAnnual Report Filing (Program
year 2021); Docket No. GNR-T-I!r"O1 2t- o t
Gold Star Communications, LLC (479011)
Dear Ms. Noriyuki:
Gold Star Communications, LLC ("the Company") hereby notifies the Commission that it
has filed its FCC Form 481with the Universalservice Administration Company ("USAC") and
files with the Commission its Affidavit and Certification by Eligible Telecommunications Carrier
of Compliance.
Request is hereby made that the Commission notify the Federal Communications
Commission and USAC, prior to October L,2O2L, that the Company is eligible to receive federal
high-cost support for the year 2022.
Questions regarding this filing should be directed to:
Michelle Motzkus
Legal & Regulatory Administrator
phone: [phone]
email: [e-mail]
Kind regards,
Re
rtsr<)
Bonnie Jackson
Legal & Regulatory Assistant
Attachment
SIvefllaf.com I PO Box226 | Freedom, WY 83120 | 877.883.24L1
State of Wyoming CERTI FICATION BY ELIGI BLE TELECOM M U NICATIONS CARRI ER
OF COMPLIANCE WITH SERVICE QUALITY AND CUSTOMER
PROTECTION, ABILITY TO REMAIN FUNCTIONAL IN EMERGENCIES,
AND USE OF FEDERAL HIGH.COST SUPPORT.
County of Lincoln
AFFIDAVIT OF BUSINESS OR CORPORATE OFFICER
The ldaho Public Utilities Commission Order No. 29841 requires that Eligible Telecommunications Carriers
(ETC) certify that it is compliant with applicable service quality standards and consumer protection rules; and
ETCs must demonstrate the ability to remain functional in emergencies. ln addition, the Commission must file
an annual certification with the USAC and the FCC that all federal high-cost support provided to ETCs within
the State of ldaho will be used only for the provision, maintenance, and upgrading of facilities and services for
which the support is intended. Accordingly, the undersigned states and verifies under oath the following:
1. I am an officer of Gold Star Communications. LLC, an eligible telecommunications carrier for receiving
federal universal service support under section 2la(e) of the Telecommunications Act of 1995 in the
state of ldaho.
2. I am familiar with the Company's day-to-day operations in the state of ldaho and with the State's
service quality standards and consumer protection rules as set forth in Commission Order No. 29841.
3. Gold Star Communications. LLC. is complying with applicable service quality standards and consumer
protection rules of the Federal Communications Commission and the ldaho Public Utilities
Commission.
4. ! certify to the Commission that the Company is able to remain functional in emergencies as set forth
in Commission Order No. 29841 and in 47 C.F.R. 5 54.201(aX2).
5. I also certify that all federal universal service support funds received by Gold Star Communications.
LLC, during the current calendar year will be used in a manner consistent with section 25a(e); that is,
for the provision, maintenance, and upgrading of facilities and services for which the support is
intended. The company will continue to comply for the period of January 1,2021, through December
31,2021, to be eligible for federal universal service fund support.
6. This verification and affidavit is provided to be the ldaho Public Utilities Commission to enable the
IPUC to certify to the FCC that federal universal service support received by the eligible carriers in the
state will be used in a manner consistent with Section 254(e) of the Telecommunications Act.
Jefferson H
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Date
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BONNIE L. JACKSONStste ol Wyoming.flotary Public
County of Lincoln
Commission ExPiresM
mber 30 2021
SUBSCRIBED AND SWORN to before me this
,{r4"rV Public tol V{ybming, residing at Lincoln County
My Commission elpires ?' >o'* t