20220128Frontier Communications Form 555.pdf

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Ziply Fiber
4155 SWCedar Hills Blvd,
Beaverton, OR 97005
Jessica Epley
M. [phone]
[e-mail]
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January 28,2022
Mrs. Jan Noriyuki
Commission Secretary
ldaho Public Utilities Commission
472 West Washington Street
Boise, ldaho 83720
RE: Docket No. GNR-T-Z?-O1 Annual Eligibility Re-Certification of Lifeline Subscribers
Dear Mrs. Noriyuki:
Ziply Fiber of ldaho, LLC dba Ziply Fiber (Study Area Code 474427) and Ziply Fiber Northwest,
LLC dba Ziply Fiber (Study Area Code 472416) hereby provide a copy of its Annual Lifeline
Eligible Telecommunications Carrier Certification FCC Form 555 in compliance with 47 CFR
54.416 as adopted by the FederalCommunication Commission (FCC) in its Lifeline Reform
Order, FCC 12-11, released February 6,2012.
Section 54.4 16(b) requires eligible telecommunication carriers (ETCs) to annually provide the
results of their re- certification efforts performed pursuant to Section 54.4 10 (0 to the FCC and
the Universal Service Administrative Company (USAC). ETGs are also required to provide the
results of their re-certification efforts to state commissions and relevant tribal governments.
Questions regarding this filing may be directed to me via email at jess.igA.CplCy@ziplLcom or
telephone at [phone].
Sincerely,
Jessica Epley
VP - Regulatory & External Affairs
W
Annual Lifeline Eligible Telecommunications Corrier Certilication Form All carriers must complete all orportions
of all sections Form must be submitted to USAC and filed with the Federal Communications Commission
IMPORTAIIT: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 3l't (Annually)
Does the reporting company have alfiliated ETCs? Yes E[ No E[
Provide a list of all ETCI that are afiliated with the reporting ETC, using page 4 and additional shee* if necessary. Afiliation shall be
determined in accordance with Section 3(2) of the Communications Act. That Section defines "afiliate" as "a person thot (directly or indirectly)
oww or controls, is owned or conholled by, or is under common ownership or control with, another person." 47 U.S.C. S 153(2). See also 47
c.r.R. $ 76.1200.
Affiliated ETC's SAC Affiliated ETC's Name
472416 143004786
Study Area Code (SAC) Service Provider ldentification Number (SPIN)
(An Eligible Telecommunications Canier @TC) must provide a ceftificationformfor each SAC through which it provides Lifeline semice).
2021 ID Frontier Communications Northwest lnc.
Recertification Year
N/A
State ETCName
Northwest Fiber, LLC
DBA, Marketing, or Other Branding Name
(If sane as ETC name, list "N/A" Do rnt leatte blank)
Holding CompanyName
(If same as ETC name, list "N/A" Do not leave blank)
1
ETCs Subject to the Non-Usage Requirements
All ETCs must complete the appropriate check-box. ETCs that do not assess and collect a monthlyfeefron their Lifeline subscribers are subject
to the non-usage requirements. ETCs subject to the non-usage requirements must indicate the nuiber ofsubscibers de-enrolled by month in
Section 4. ETCs that only assess afee but do not collect suchfees are subject to the non-usage requirement$ and mwt also indicate the number of
subscibers de-enrolled by month.
Is the ETC subject to the non-usage requirements? Yes E[ No E[
If yes, record the number of subscibers de-enrolled for 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
May 0
June 0
Julv 0
Auzust 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 fonnation,
or other similar legal document. An officer is a person who occupies a position specified in the corporate by-laws (or
parhership 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 Certilicatiott Att ETCs nust complere rtis section
I certi$ that the company listed above has certification procedures in place to:
A) Review income and program-based eligibility documentation prior to emolling 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 administator 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.
BESInitial
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 attemptsC. Total number of subscribers ETC is responsible for recertiling (A-B)
Recertilication Methods
Stete of federal databaseD. Subscribers recertified through ETC access to state or federal database by anniversary month
subscnlbers verified access to a stat€ or ftd€ral dstabas€.
E. Name of the data source(s) used to veriry consumer eligibility:
ETC Direct ContactF. Subscribers contacted by ETC directly to rec€fiiry (You may also use this section to report subscnter initiated recertifications).
the number subacribers the ETC contacted to obtain recertification of
G. Subscribers who failed to recertifr through ETC direct outreach attempt
the number subscribers de-eirolled due to or to the ETC's outreach
the
3
Jen Feb Mer Apr May Jun Jul Aug sep Oct Nov Dec Yeor
Totd
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
APr May Jun Jul Aug Sep Oct Nov Dec Year
Totel
Jen Feb Mar
D.0 0 0 0 0 0 0 0 0 0 0 0 0
Jan Mar Apr May Jun Jul Aug sep Oct Nov Dec Year
Total
Feb
F.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 Ycor
Total
G.0 0 0 0 0 0 0 0 0 0 0 0 0
H. Subscribers who recertified through ETC direct outreach attempt
the number oflifeline subscribers that 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 state third or USAC for the ofrecertification.
J. Name of third party administrator used to verif subscriber eligibilityl
K. Subscribers de-enrolled as a result ofa third party recertification attempt
the number ofsubscribers as a result of or to outreach fiom a state adminisuator, third
L. Subscribers who recedified through a state adminishator, third party administrator, or USAC's recertification effort
the number ofsubscribers that recemified ftom a state thftd oTUSAC
or USAC.
a
Certilication:
Recertification Method: Database
I certifr that the company listed above has procedures in place to recemiff consumer eligibility by relying on a database. I
am an oflicer of the company named above. I am authorized to make this certification for the SAC(s) listed above.
Iritiat BES
4
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Yer
Total
H.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
Totel
I.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
Totel
K.0 0 0 0 0 0 0 0 0 0 0 0 0
Jan Feb Mrr Apr Mey Jun Jul Aug sep Oct Nov Dec Yeu
Totd
L.0 0 0 0 0 0 0 0 0 0 0 0 0
Recertification Method: ETC
I certi$ 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.
664 BES
Recertification Method: Third Party
I certiS 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.
1ni1is1 BES
No Subscribers
I certifu 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.
16611 BES
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.
Sigrred,
Byron E Springer, Jr, General Counsel Byron E Springer, Jr, GeneralC<
Signature of Ofiicer
[e-mail]
Email Address of Officer
Byron Springer
Person Corylaing This Certification Form
Printod Name and Title of Officer
Jan26,2022
Date
206-890-3047
Contact Phone Number
14 = (G+K)1r1 = @+F+I)O = M/l{*101)
Total number of subscrlbers de-enrolled as
a result of recertification
Total number of subgcriberc ETC is
responrlble for recertifying
Percent of subscrlbers due for
recertification who were deenrolled
0 0 0.0o/o
5
Affiliated ETCs
SAC Name
533401 CITIZENS TELECOMM CO OF OREGON
532416 Frontier Communications Northwest lnc
522416 Frontier Communications Northwest lnc.
522449 Frontier Communications Northwest lnc.
474427 CITIZENS TELECOMM CO OF IDAHO
484322 CITIZENS TELECOMM CO OF MONTANA
5