20220131CenturyTel of the Gem State Form 555.pdf

LUMEN"
January 31,2022
Via Email Submission
s e c r e ta r1@p u a i d a h o. g o v
Ms. Jan Noriyuki, Secretary
Idaho Public Utilities Commission
11331 W. Chinden Blvd., Bldg. 8, Ste. 201-A
Boise, ID 83714
Docket No. GNR-T-22-01
CenturyTel of the Gem State dba CenturyLink- 2021 Lifeline
Re-Certification Results Reported to the FCC and USAC
Dear Ms. Noriyuki
Pursuant to the Federal Communications Commission's Report and Ordert requiring
eligible telecommunications ca:riers to re-certifr the eligibility of their Lifeline subscribers and
to report the results to the Federal Communications Commission, Universal Service
Administrative Company and to state commission and Tribal governments, CenturyTel of the
Gem State dba CenturyLink hereby submits its202l Lifeline re-certification results for the state
of Idaho.
Please note that the results are provided separately for each FCC study area. [n addition,
the numbers being reported this year are mostly zero as we are no longer handling the
verifications and recertifications. The Lifeline National Eligibility Verifier (National Verifier)
has taken over these functions for all states except the Opt-out-states of Oregon and Texas. Per
USAC's instructions, we are still completing and filing the Form 555 reports; only we are filling
them in with zeros where the National Verifier has taken over.
Please do not hesitate to contact me at (303)-992-5810 or via e-mail at
[e-mail] should you have any questions regarding this filing.
Sincerely,
lsl Timothy D. Kunkleman
Timothy D. Kunkleman
Director, Government Affairs
TDIUjga
Attachments
In the Matter of Lifeline and Link Up Reform and Modemization, Lifeline and Link Up, Federal-State Joint
Board on Universal Service, Advancing Broadband Availability Through Digital Literacy Training, Report and
Order and FurtherNotice of Rulemaking,2T FCC Rcd 6656,6715-16fl132(2012);47 C.F.R. $ 54.416. Also
see Public Notice, 28 FCC R:cd 12947 (2013).
Re
931 14t' Street
Denver, CO 80202
303-992-581 0
Timothy. [e-mail]
Annual Lifeline Eligible Telecommunications Carrier Certilication Form All carriers must complete all or portions
of all sections Form must be submitted to USAC and filed with the Federal Communications Commission
IMPORTAI\T: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 31st (Annually)
Does the reporting company have alfiliated ETCs? Yes EE No E[
Provide a list of all ETCs that are afiliated with the reporting ETC, using page 4 and additional sheets if necessary. Affliation shall be
determined in accordance with Section j(2) of the Communications Act. That Section defines 'afliliate" as "a person that (dircctly or indirectly)
owns or controls, is owned or controlled by, or is wtder common ownership 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
472223 143002667
Study Area Code (SAC) Service Provider Identification Number (SPbf)
(An Eligible Telecommunications Carrier @TC) must proide a cenificationformfor each SAC through which it provides Lifeline service).
2021 ID CenturyLink CenturyTel of the Gem State (Nevat
Recertification Year
N/A
State ETCName
Lumen Technologies, lnc.
DBA, Marketing, or Other Branding Name
(lf same as ETC name, list "N/A" Do rct leave blank)
Holding CompanyName
(If same as ETC name, lis, "N/A" Do rot 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 monthlyfeefrom their Lifeline subscibers are subject
to the non-usage requirements. ETCs subject n the non-usage requirements must indicate the number of subscribers 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 EE 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
Mav 0
June 0
July 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 formation,
or other similal legal document. An officer is a person who occupies a position specified in the corporate by-laws (or
parbrership agreement), and would tlpically be president, vice president for operations, vice president for finance,
comptroller, ffeasurer, or a comparable position. If the filer is a sole proprietorship, the owner must sigrr the certification.
Initial Certificatiorl Alt ETCs must complete this section
I certiS that the company listed above has certification procedures in place to:
A) Review income and program-based eligibility documentation prior to 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) Confrnn 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.
AGInitial
2
Annual Recertification
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 prior to recertification attemptsC. Total number of subscribers ETC is responsible for recerti$ing (A-B)
Recertification Methods
State of federal databaseD. Subscribers rec.ertified though ETC a@ess to state or federal database by anniversary month
the number of subscnlbers verified access to a or federal database.
E. Name of the data sourc{s) used to verifo consumer eligibility:
ETC Direct ContactF. Subscribers contacted by ETC directly to recertiS (You may also use this section to report subscniber initiated recefiifications).
the number of Lifeline to
G. Subscribers who failed to recertiff througlt ETC direct outreach attempt
the number of Lifeline or to the ETC's outeach
3
Jan Feb Mar Apr May Jun Jul Aug sep Oct Nov Dec Yeor
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
Jrn Mar Apr May Jun Jul Aug sep Oct Nov Dec Ycar
Totel
Feb
0 0 0 0 0 0 0 0 0 0D.0 0 0
Sep Oct Nov Dec Yerr
Totd
Jan Feb Mer Apr Mey Jun Jut Aug
0 0 0 0 0 0 0 0 0 0F000
Aug sep Oct Nov Dec Year
Totrl
Jan Feb Mar Apr May Jun Jut
0 0 0 0 0 0 0 0 0G,0 0 0 0
H. Subscribers who recertified through ETC direct outreach attempt
the number ofLifeline subscribers that
Third Party
I. Subscribers whose eligibility was reviewed by state administrator, third party administrator, or USAC
the number of Lifeline subscribers contacted a state administrator thid or USAC for the of recertificatim.
J. Name of third party administrator used to veriry subscriber eligibility:
K. Subscribers de-enrolled as a result ofa third party recertification attempt
fte number of subscribers as a result or to outreach from a state lhird administrator orUSAC.
L. Subscribers who recertified through a state adminishalor, third party administratoq or USAC's recertification effort
the number ofsubscribers that recertified a from a state lhtd or USAC
Certification:
Recertifi cation 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 named above. I am authorized to make this certification for the SAC(s) listed above.
Initial
4
Jan Feb Mar Apr May Jun JUI Aug sep 0ct Nov Dec Year
Total
H.0 0 0 0 0 0 0 0 0 0 0 0 0
Jan Feb Mar Apr May Jun JUI Aug sep Oct Nov Dec Yerr
Totel
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 Dec Year
Totel
K.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
L,0 0 0 0 0 0 0 0 0 0 0 0 0
Recertilication Method: ETC
I certi$ that the company listed above has procedures in place to recerti$ the continued eligibility of all of its Lifeline
subscribers, and that, to the best of my knowledge, the company obtained sigrred 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
Recertification Method: Third Party
I certi$ that the company listed above has procedures in place to recertiff consumer eligibility by relying on an
administrator. I am an ofticer 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
data year. I am an officer of the company named above. I am authorized to make this certification for the SAC listed
above.
Initiat AG
Signature Block
By signing below, I certify 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,
Andrea Genschaw SVP Controller Andrea Genschaw SVP Controll
Sigtature of Officer
ANDREA.GENSCHAW@LU M EN
Email Address of Officer
Heather Malone
Penon Complaing This Certification Form
Printod Name and Title of Officer
Jan 31 ,2022
Date
3183306442
Contact Phone Number
y=(a+K)N = (D+F+r)O = M/Nrlfi)
Total number ofsubscribers de-enrolled as
a result of recertiflcation
Total number of subscribers ETC ls
responsible for recertifying
Percent ofsubscribers due for
recertification who were deenrolled
0 0 0.0%
5
Affiliated ETCs
SAC Name
472225 CenturyLink CenturyTel of ldaho lnc.
475103 Genturylink Qwest Comoration
475162 CenturyLink Qwest Comoration
6