20210701Q Link Wireless Form 481 and Affidavit.pdf

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<01(D StudyAreaCode 479018
<015> Study Area Name 0 unr rrrererr ur
<020> ProSramYear 2022
<030> ContactName: Person UsAcshouldcontact
with questions about this data Herther Rirby
<035> ContactTelephone Number:
Number ot the person identified ln data line <030>
17O2Z27eOE exE
<039> Contact EmailAddress:
Email of the person identilied ln data line <030> etcetel€cmffitel 'cm
FormType st.t22
..' t:].- -l L4ll'hIrlr- -,,I{r;, k tfri1::l*. kffi ffi{'.}rr.- I t,.f,1t,,r, I !/
a'\ I rl
t- i,drr S*F --E i46nsgN]OLo?
Service Outage Reporting (Volce)
Collectlon Form
<010> Study Area Code
fCC Form {81
OMB Control No. 3
Dccemb€r 2020
47901a
<015> StudyArea Name Q Link wireless LLC
<020> Program Year
<030> Contact Name - Person USAC should contact regarding this data Heather Kirby
<035> ContactTelephoneNumber-Numberofpersonidentifiedindataline<O3O> 770232780s ext'
<039> Contact Email Address - Email Address o
<210> For the prior calendar year, were there any reportable voice service outages?
<220> <a> <b1> <b2> <b3> <b4> <c1><c2><d><e><f>
Did This Outat
Affect Multipl
Study Areas
NORS
Reference
Number
Outate Start
Date
Outage Start
Time
Outage End
Date
Outage End
Time
Number of
Customers Affected Total ,{umber of
Customers
911 Facilities
Affected
(Yes / No)
S€rvice Outate
Description (Check
all that aoolvl
Itloot
lo.t.
Ilumber of Complalnts per l1XXl custornels
Collectlon Form
FCC Form 48,
OMB Control
Decamtcr202
<010> StudyArea Code 4 79018
<015> Study Area Name Q Link wireless LLc
<020> Program Year 2022
<030> Contact Name - Person USAC should contact regarding this data Hearher Kirby
<035>Contact Telephone Number - Number of person identified in data line
<030>7702327805 exlc
<039>Contact Email Address - Email Address of person identified in data line
<030>
etco[elecomcounsel - com
<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
<42O> Complaints per 1000 customers for mobile voice
<o1(}> shdyAreacodc a?9018
<015' SrudyArGq llsme 0 Li.nk gnrcl6., I&'c
dm> ProrremYaar ?o4
<)3(}, Codtact.ilaiDe - PerBon USAC ihould qln@ct rssrrdlnr tfils data Eotlt!{ir r{.ity
<)!ls> contect Td€Dhon. tlumber . t{umbs of oerson ldendf,ed ln d.ta line <()!1(}, 7?0232?805 st '
<03$ COnhct f,mall lddr€$ - Eroall .Addrcss of percon ldcntlficd ln dab fine <030> .tslt :'.6ooun3.1 . cor!
€trs> C€Idfy cmlrpllancewlth applicable mlnimum scfllce tt nderds
<ll0> StrdyAreaCode {79otrS
<015r StudyAr.ea ilame O link ttlaIelr lillc
<02D ProgramYear 2022
<030> gontagt ,'lerne - Fergon USAC should contact regarding this data flaatlqr rigDlr
<)35> @ntad Telcphone Number - Numbs of person ldentlfied in data llne <)3D 7702327805 erct
<0:r$ ContEGt Emall Addr€os - Emsil Address of pelron i&ntlft€d h dsta line <OB0> Gttatterc€oocqrarril.doo
<600D Certlfu ol1pliane reprding abllity to ftrnstion in emargency shuutions
<6tro> Descrlptive docr.ment fior Funetionaltty in Eme_rgency Situatbns
l(8001
l'"'
Operatlng Companles
Collectlon Form
FCC Form 481
OMB C.ontrol No. 3060
December 2020
<010> Study Area Code 47901A
<015> Studv Area Name
<020> Program Year 2022
<030> contact Name - Person USAC should contact regarding this data u6.rh6r ri 7hl,
<035> Contact Te Number of identified in data line <030> '7'70232780s ext
<039> Contact Email Address - Email Address of person identified in data line <030> erc@relecomcowsel . com
<810> ReportinECarrier O LINK WIREI,ESS LLC
<811> Holdins Comoanv OUADRANT HOLDINGS GROUP LtC
<812>
<813>
LINK WIRELESS LLC
<a1>
Affiliates sAc
<a2><a3:
Doing Business As Compan
<l1O> Studv Area Code '179018
<015> StudyArea Name Q Link wirele8s LLC
<020> Program Year 2022
<030> Contact Name - Person USAC should contact this data
<035> Contact Telephone Number - Number of person identified in data line <030>
HeaEher Kirby
<039> Contact Email Address - Email Address of person identlfied in data line <O30>etc@telecomcouael. com
<900> Does the filing entity offer tribal land services? (Y/N)
<910> Tribal Land(s) on which ETC Serves
<920> Tribal Government EngagementObligation
lf your company serves Tribal landt please select (Yes,No, NA) for each these boxes
to confirm the status described on the attached PDF, on line 920,
demonstrates coordination with the Tribal government pursuant to
5 54.313(al(5) includes:
,
<92L>Needs assessment and deployment planning with a focus on Tribal
community anchor instifu tions.
Feasibility and sustainability planning;
Marketing services in a culturally sensitive manner;
Compliance with Rights of way processes
Compliance with Land Use permitting requirements
Compliance with Facilities Siting rules
Compliance with Environmental Review processes
Compliance with Cultural Preservation review processes
Compliance with Tribal Business and Licensing requirements.
Name of Attached Document
<922>
<923>
<924>
<925>
<926>
<927>
<928>
<929>
Select
Yes or No or
Not Applicable
{\k\\\}j\\r!.E&'+E LA'G1
<010>Area Code
<015>Area Name
<020> Program Year
479018
I nlnk rllaless LLC
2022
<030> Contact Name - Person USAC should contact this data Il€alhe! lilrby
<035> Contact Number- Number line <030> 77o23278os ext
ress of Derson identified in data line <030> etccBelecmmrcl.cm<03$ Contact Address -
<1000>Volce sorvices rate comparability certifi cation
<1010>Attach detailed description for voice services rate
comparability compllance
<102(>Broadband comparability certlflcatinn
<103(>Attach detalled descrifiion for broadband
comparabillty compliance
Name of Attached Document
Name of Attached Document
<010> StudyArea Code 479018
<015> StudyArea Name Q Link wireless LLC
<020> Prosram Year 2022
<030> Contact Name - Person USAC should contact regardingthis data Heather Kirby
<035> Contact Telephone Number - Number of person identified in data line <030>7102321805 exL
<039> Contact Email Address - Email Address of person identified in data line <030>et s@telecomcouael . con
<1100> Certify whether terrestrial backhaul options exist (Y/N)
<1130> Please select the appropriate response (Yes, No, Not Applicable) to confirm the
reporting carrier offers broadband service of at least 1 Mbps downsfeam and 256 kbps
upstream within the supported area pursuant to $ 54.313(9).
<1140>Alaska Plan rate-of-return certification (yes, no, or not applicable) of
compliance with approved performance plan.
<010> StudyArea Code '[?9018
<015> StudyArea Name o LIlk tllr6leB6 u,c
<020> ProgramYear
<030> Contact Name - Person USAC should contact qegarding this data Eeatber Kirby
<035> Contact Telephone Number - Number of person identifled ln data llne <030>7702327805 Gxt
<039> Contact Emall Address - Email Address of person identlffed in data line <030>etcatelffi€l.m
<1210> Terms & Conditions of Voice Telephony Llfeline Plans
<7220> Link to public Webslte HTTP
'Please check these boxes below to conftrm that the attached document(sl, on llne 1210,
or the website listed, on line 122O contains the requlred informatlon puBuant to
5 5a.422(a[2) annual reportingfor ETCs receMng low-income support, cariers must
annually report:
<7221> lnformation describlng the terms and conditlons of any volce
telephony seMce plans offered to Lifeline subscribers,
<L222> Details on the number of minutes provided as part of the plan,
O Llrk 1210_202rycmrlc aith tri.brl,pdf
Nam€Document
<L223> Additional charges for toll calls, and rates for each such plan.E
<010>Area Code 479019
<015> StudvArea Name s IJ,C
<020> Program Year 2022
<O3O> Contact Name - Pers
<035> Contact Number - Number tn line <030>ext
<039> Contact etc@telecomcougel. com
Select the appropriate responses below (Yes, No, Not Applicable) to note compliance as a recipient of frozen High Cost s
to offtet access charge reductions, and Connect America Phase ll support as set forth in 47 CFR 54.313(c),(d),(el. The inf
form and in the documents attached below is accurate.
<2015> 2015 and future Frozen Support Certification 47 CFR 5 54.313(cX4) f
Price Cap Carrier Connect America ICC Support (47 CFR 0 54.313(d))
<2OL6> Certification support used to build broadband
Connect America Phase ll Reporting {47 CFR I 5 313(e}}
<2017A> Connect America Fund Phase ll recipient?
<20L7C> Total amount of Phase ll 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(eXfXiiXe)
Connect America Phase Il - FCC Form 470 Postings
<2019> For the filing due July 1 following full implementation of this requirement,
answer yes, no, or not applicable to this certification request
Name of Attached Document Listing
Required lnformation
I
<01D StudyArea Code 47 90]-8
<015> StudyArea Name O Link lilireless LI
<020> Program Year 2022
<030> Contact Name - Person USAC should contact regarding this data Heather Kirby
<035> Contact Telephone Number - Number of person identified in data line <030>7702327805 ext.
<039> Contact Email Address - Email Address of person identified in data line <030>etc@telecomcounsel
(3007)Does this filing retaln 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?
Name of Consultant Name of Consultant
{!1005} Rate Of Retum Carrler Addltlonel Documentatlon
Data Collectlon Fo]m
FCC Form 481
OMB Control No
December 2020
<010> Study Area Code 47 90.1 R
<015> Study Area Name O Link Wireless LLC
<020> Program Year 2022
<030> Contact Name - Person USAC should contact regarding this data Heat.her Kirby
<035> ContactTelephoneNumber-Numberofpersonidentifiedindataline<030> 7702327905 ext.
<039> Contact Email Address - Email Address of person identified in data line <030>et c@te l-ecomcounse l- . cor
Name of Attached Document Listing Required
lnformation
Name of Attached Document Listing
Required lnformation
(Yes/No)
(Yes/No)
Name of Attached Document Listing Required
lnformation
Select from the drop down menu or check the boxes below to note compliance with 54.313(f)(1). Privately held carrier
financial reporting requirements set forth in 47 CFR 54.313(fX2). I further certify that the information reported on this
attached below is accurate.
(3009) Progress Report on 5 Year Plan
Carrier certifi es to 54.313(fXlXiii)
(3010A)
(30108)
(3012A)
(30128)
(3013)
(3014)
(301s)
(3015)
(3017)
Certification of Public lnterest Obligations {47 CFR S
s4.313(f)(1)(i))
Please Provide Attachment
Rate-of-Return Community Anchor Institutions
lndicate 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. S s4.313(fXlXii)
ls your company a Privately Held ROR Carrier {47
cFR S s4.313(f}(2))
lf 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(fX2) compliance
requires:
Electronic copy of their annual RUS reports
(Operating Report for Telecommunications
Borrowers)
Document(s) with Balance Sheet, lncome Statement
and Statement of Cash Flows
lf the response is yes on line 3014, attach your
company's RUS annual report and all required
documentation
lf the response is no on line 3014, is your company
audited?
lf the response is yes on line 3018, please check the
hawac hala.., ia anafirm ',a',r cr,lraiccian an lina
o
I
(3018)(Yes/No)OC
Fln nchl Dat SumnBry
(3027) Revenue
(3028) OperaUng Expenses
(3029) Net lncome
(3030) Telephone Plant ln SeMce[fPE)
(3031) Total Assets
(3032) Total Debt
(3033)Total Equity
(3034)DMdends
N.mof Attdt.d DocumtLBdlu R.aulnd lnbmribn
<010>Study Area Code 479018
<0L5>
<020>
Area Name
Program Year
Q Link wlreLes8 LLC
2022
<030>
<035>
Contact Name - Person USAC should contact this data Heather Klrby
Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>etc6teleqoncouaeL. con
rO05 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 lnterest Obligations - FCC 1&98 (paragraphs 2&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 lnstitutions
<4003a> lndicate 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 lnformation
(50051 Alaska Plan Participants Additional Documentation
Data Collection Form
<010>Study Area Code
FCC Form tl81
OMB Control No. 306
December 2020
479078
<015>Study Area Name O Link wireless LLC
<020>Program Year 2022
<030>Contact Name - Person USAC should contact regarding this data Heather Kirby
<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>etc@teleconcowsel . con
5005 Alaska Plan
(s011,)
(s012)
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.
lf the filing carrier identified in its approved perfomance plans that it relies exclusively on
satellite backhaulfor 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
<a><b>
Description Of Backhaul Technology
(Yes/Nr
(Yes/Nc
Newly Served Loc
<5013>
Date Eackhaul Available
{6005} Phase ll Auction Reporting
Data Collection Form
<010>Study Area Code
FCC Form tl8l
OMB Control No. !
December 2020
41 90r8
<015>Study Area Name 0 Link Wireless IJLC
<020>Program Year
<030> Contact Name - Person USAC should contact regarding this data Hearher Kirby
<039>Contact Email Address - Email Address of person identified in data line <030>etc@telecomcousel - com
<6010> Enter the total amount of Phase ll Auction Support, if any, the carrier used
for capital expenditures
Phase ll Auction and New York Funds Certification
<5011>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
Phase ll Auction Community Anchor lnstitutions
<6012a> lndicate 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 llAuction 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 !l 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 ll-funded network that the Phase ll auction
recipient operated in the prior year meets the relevant performance
requirements in 5 54.309
(Yes/No)
Name of Attached
Document Listing Required
lnformation
<6014>
<010>Study Area Code 479018
<015>Study Area Name 0 Link l{lrelers LLC
<020>Program Year 2022
<030>Contact Name - Percon USAC should contact regarding this data Heatsher tdrby
<035>ContactTelephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <030>etcotelecmmael.cm
<7010> Phase ll Auction recipient performance requirements certification (Yes/No)
(8(X15) Uniedo a Puerto Rico Fixed and Mobile Funds Ceffication
Data Collection Form
FCC Form 481
OMB Control No. 3061H
December 2020
<010>
<015>
Stud Area Code
Study Area Name
479018
O Link Wireless LLC
<020>Program Year 2022
<030>Contact Name - Person USAC should contact regarding this data Heather Kirby
<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>etc@telecomcounsel . com
<8010>
<8011>
<801.2a>
<8012b>
<8013>
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 tnstitutions
lndicate 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. $ 5a.313(eX2)(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.
Name of Attached
Document Listing R,
lnformation
<8014>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.
<8020>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.
<8030> I taiaar{a a Drra;}a Diaa C}aaa I Eivaz{ - I'licac}ar Draaararlnacc anr{ Dacnaaca t.laarraaa}atian
(9fi15) Connect USVI Fixed and Mobile Funds Certffication
Data Collection Form
<010>
FCC Form 481
OMB Control No. 3060-
December 2020
Study Area Code 47 9078
<015>Study Area Name O Link Wilele8s LLC
<020>Program Year 2022
<030> Contact Name - Person USAC should contact regarding this data Hearher Kj.rby
<039>Contact Email Address - Email Address of person identified in data line <030>etc@telecomcounseL . com
<9010>
<9011>
<9012a>
<9012b>
<9013>
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 expenditu res.
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 lnstitutions
lndicate 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. $ S+.3r3(eXZXiXn).
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 5 54.309.
Connect USVI Stage 2 Fixed - Support Reimbursement Certification
5a.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.
Name of Attached
Document Listing
lnformation
<9014>
<9020>
Connect USVlStage 2 Fixed - Disaster Preparedness and Response Documentation
Page 21
<01D StudyArea Code 4? 9018
<015> StudyArea Name O Link Wire1e88 IrIJC
<020> Program Year 2022
<030> Contact Name - Person USAC should contact rerardinp this data Heather Klrby
<035> ContactTelephoneNumber-Numb€rofpersonidentifledindataline<030> 170232780s ext-
<039> Contact Email Address - Email Address of person identified in data line <03D ercoreteconcouEel .com
TO BE COMPLETED BY THE REPORTIilG CARRIER, IF THE REFOR:IIITG CARRIER IS FIUI{G AilT{UAt RCPORflilG ON TTS OWil BE}IALF:
Certificatlon of fficer as to the Accuracy of the Data Reported for the Annual Reportlng for CAF or U Reclpients
c.rtify that I !m .n oficcr of thc rcpordnS canief nry responslblllties lncluda cnsudnS the accuracy of the annurl reportlng requlremants for univarsal serulce support
|Cdpient3; tn4 to tha bcst o, my knowhd&, th! lnfofmeton ,cportad on ttls rorm rnd in any attadrmGntr ls acq|retr.
Name of Remrtinr Carrier:
ilqnature of Authorized Offi cer:Date
Printed name ofAuthori2ed officer:
ntle or msition of Authorized Officer:
feleohone number of Authorired Ofiicer:
itudv Area Code of Remrtine Carrier:Fllln! Due Date for this fo.m:
Pcrcns willfully m8klng fal* stat€ments on this form c.n be punishcd by finc or forfciture undcr thc Clmmuniet'pns Act of 1934, 47 U.s.c. 95 502, 503(bl, or fin! or imprlsnmcnt
under Tith 18 ofthe Unitcd Stat6 Cod€, 18 U.S.C. S 1001.
Page 21
Page 22
Ccillficrtion - Ag€nt r/ Grrier
Drta Collection Form
FCC Form i181
oMB Conrol No. 3060{I985/OMB Conrrol ilo. 3mlxtsrg
O.canb.r2@0
<010> StudvArea Code 4?9018
<015> StudyArea Name Q Link wireless LLC
<020> Program Year 2022
<030> Contact N.me - Person USAC should contact recardinc this data Heat.her Ki
<035> contactTelephoneNumber-Numberofpersonidentifiedindataline<o3o> 7102327805 exL
<039> contact Email Address - Email Address of person identified in data line <o3o> etc@telecomcounsel ' com
TO BE COMPTETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING ANNUAL REPORTS ON THE CARRIER'S BEHALF:
TO BE COMPTETED BY THE AUTHORIZED AGENT:
Certification of Officer to Authorize an Agent to File Annual Reports for CAF or Ll Recipients on Behalf of Reporting Carrier
l certfy that (Name of Agent) 8rcert Telecon Co l ls authorlzed to submlt the lnfoma0on reported on behalf of the rcpordng carrler
also cerdfy that I am an offfcer o{ the reportng carder; my r$pon3lbilld6 lncludo sn3urlng the accuracy of the annual data repordng requlrsmenb provided to tho authorlzed
agent; and, to lhe bst of my knoylodgo, the reporB and data provlded to the authdized agent lE accurate.
NameofAuthorizedApent: Expert Telecom Compliance
NameofReDortinsCarrier: O l,ink wirele6s LLC
Sirnature of Authorized Officer: CERTIFIED oNLINE Date: 06 / 3a / 202a
Printed nam€ of Authorized officer: rssa Asad
fitle or position of Authorized officer: CEo
Ielephone numberof Authorized Officer: 8005101540 ext
Studv Area Code of Reoortin€ Ca rrier: 4 ? 9 0 1 8 Filinr Due Date for thisfotmt o't / ot/2o2t
under Title 18 of the Unlted States Code, 18 U.S.C. I 1001.
Certification of Agent Authorized to File Annual Reports for CAF or Ll Recipients on Behalf of Reporting Carrier
the data reponed hereln based on data prorlded by the reporting carrier; and, to the best o, my knowl€dte, the informatlon reponed hetein ls accurate.
NamE of ReDodinc crrrier:O Link wireless LLC
Name of Authorized Acent Fim:Expert Telecom Conpliance
Sitnature ofAuthorized A{ent or EmDlovee ofASent: CERTIFIED ONLINE Date: 06/30/2027
Maddy RobertaName of Authorized Asent EmDlovee:
fitleorDositionofAuthorizedArentorEmoloveeofAsent Requlatory specialiEt
feleohone number of Authorized Arent or EmDlovee of Asent: 1 1 o212g2oo exL
Studv Area Code of Reoortins Carrier:4'7 9078 Filins Due Date for this form:n1 ln1 l)n)1
18 of the United States code, 18 u.S.c. 5 1001.
Page 22
!179018<010> StudyArea Code
O rJl.Dk ll1r61e.. LIlc<015> StudyArea Name
<02D ProgramYear 2022
<030> Contact Name - Person USAC should contact regarding this data Heather Klrby
7?02327805 er*.<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>etqrteleconcmaol.ffi
I certify under penalty of perjury that no universal service support has been or will be used to purchase,
obtain, maintain, improve, modiff, or otherwise support any equipment or services produced or provided
by any company designated by the Federal Communications Commission as posing a nationalsecurity
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
State of Florida
County of Broward
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CERTIFICATION BY ELIGIBLE TELECOMMUNICATIONS CARRIER
OF COMPLIANCE WTH SERVICE QUALITY AND CUSTOMER
PROTECTION, ABILITY TO REMAIN FUNCTIONAL IN
EMERGENCIES, AND USE OF FEDERAL HIGH.COST SUPPORT.
AFFIDAVIT OF BUSINESS OR CORPORATE OFFICER
The ldaho Public Utilities Commission Order No. 29841requires that an Eligible Telecommunications
Carrier certifo that it is compliant with applicable service quality standards and consumer protection rules;
and ETCs must demonstrate the abili$ 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 Q Link \Mreless LLC, an eligible telecommunications carrier for receiving federal
universal service support under section 214(e) of the Telecommunications Act of 1996 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 quali$ standards and consumer protection rules as set forth in Commission Order No.
29841.
3. Q Link Wireless LLC is complying with applicable service quality standards and consumer
protection rules of the Federal Communications Commission and the ldaho Public Utilities
Commission.
4. I certify to the Commission that the Company is able to remain functional in emergencies as set
forth in Commission Order No. 29841and in 47 C.F.R. S 5a.201(aX2).
5. I also certify that all federal universal service support funds received by Q Link Wireless LLC
during the current calendar year will be used in a manner consistent with section 254(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 1,2022, through
December 31,2022, to be eligible for federal universal service fund support.
5. 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.
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lssa Asad, CEO
/,/J//)/
Date
SUBSCRIBED AND SWORN to before me tnis3D day of U h..{.- zo21I
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My Commission Expires 1 25'IO Z'L
Form 481 section 1210 Q LINK WIRELESS LIFELINE OFFERING Effective l2lll2020
LIF'ELINE NON.TRIBAL:
Bundle Plan (O LIttK ALWAYS ON|
1,000 anytime minutes per month
Unlimited text and picture messaging
4.5 GB data per month
Minutes & data do not rollover
Net cost to Lifeline customer: $0
LIX'ELII\"E TRTBAL:
TRIBAL Bundle PIan (O LI\K ALWAYS ON TRIBAL)
Unlimited anytime minutes per month
Unlimited text and pictue messaging
Unlimited data per month
Net cost to Tribal Lifeline customer: $0
All packages include:
o Free calls to Q LINK Customer Serviceo Free calls to 9l I emergency serviceso Free access to Voicemail, Caller-ID, and Call Waiting featureso Voice minutes may be used for Domestic Long Distance at no exta charge
Additional airtime available for purchase
Current rates published at https://qlinkwireless.com/members/cartlquickpurchase.aspx