20230703i-wireless LLc ETC Affidavit_ Form 481 .pdf

RECEIVED
2023 JULY 3, 2023 7:30AM
IDAHO PUBLIC
UTILITIES COMMISSION
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 with questions about this data
<035> Contact Telephone Number:
Number of the person identified in data line <030>
<039> Contact Email Address:Email of the person identified in data line <030>
Data Collection Form
Filing Type
<035> Ext:
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
Low Income (54.422)
[phone]
I-Wireless, LLC dba Access Wireless
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> Upload Service Outage Data
<b1><b2><b3><b4><c1><c2><d><e><f><g><h>
NORS
Reference
Number
Outage Start
Date
Outage Start
Time
Outage End
Date
Outage End
Time
Number of
Customers Affected Total Number of
Customers
911 Facilities
Affected
(Yes / No)
Service Outage
Description (Check
all that apply)
Did This Outage
Affect Multiple
Study Areas
(Yes / No)
Service Outage
Resolution
Preventative
Procedures
<210>For the prior calendar year, were there any reportable voice service outages?
<a>
Name of Attached Document
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
attachmentSortOrder=0,
attachmentPageIndexOn
eBased=26,
attachmentNumRows=13
I-Wireless, LLC dba Access Wireless
<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
Page 3
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
<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>
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
(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>
Page 4
Page 4
<515> Certify compliance with applicable minimum service standards
Jen Rose
2024
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
<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
Jen Rose
2024
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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>Operating Company
<813>
<a3>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
<813>
<a3>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
<813>
<a3>
Doing Business As Company or Brand Designation
<a1>
Affiliates
<a2>
SAC
<813>
<a3>
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
Name of Attached Document
Upload Operating Company Data
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
attachmentSortOrder=1,
attachmentPageIndexOneBased=
27,
attachmentNumRows=23
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
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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
Jen Rose
2024
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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.
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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,
IWI 1210 templates 2023 ID.pdf
Jen Rose
2024
4
4
4
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
https://www.accesswireless.com/support/termsandconditions
Page 11
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>
Select the appropriate responses below to note compliance as a recipient of frozen High Cost support, High Cost support to offset access charge
reductions set forth in 47 CFR 54.313(c),(d). The information reported on this form is accurate.
<2015> 2016 and future Frozen Support Certification 47 CFR § 54.313(c)(4)
Price Cap Carrier Connect America ICC Support {47 CFR § 54.313(d)}
<2016> Certification support used to build broadband
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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?
Jen Rose
2024
[e-mail]
479020
[phone]
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>
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.
(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
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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>
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
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
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>
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
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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)
Newly Available Terrestrial or other Satellite Backhaul (RoR Carriers)
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.
Newly Available Terrestrial or other Satellite Backhaul (CETC Carriers)
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
Name of Attached Document
Upload Backhaul Technology Data
Jen Rose
2024
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
attachmentSortOrder=2,
attachmentPageIndexOneBased=
28,
attachmentNumRows=23
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>
(Yes/No)
Page 17
<6012a>
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.
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, no, or not applicable 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, no, or not applicable) 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
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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>Price Cap Carrier and Fixed Competitive Eligible Telecommunications
Carrier Transitional Support Requirement Certification
(Yes/No)
Page 18
Please provide a response (either yes or no) to this certification
request. Any price cap carrier or fixed competitive eligible telecommunications carrier that elects to continue receiving support
pursuant to §54.312(d) or §54.307(e)(2)(iii) starting July 1, 2020 and
annually thereafter on July 1 for each subsequent year they receive
such support, that all such support the company received in the previous year was used to provide voice service throughout the high-
cost and extremely high-cost census blocks where they continue to
have the federal high-cost eligible telecommunications carrier
obligation to provide voice service pursuant to §54.201(d) at rates that are reasonably comparable to comparable offerings in urban
areas. This certification is required by 47 C.F.R. § 54.313(m).
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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 1 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. As required by 47 CFR Section 54.313(e)(2)(i)(A), attach the document which contains the community anchor institution details.
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 1 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
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
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 1 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. As required by 47 CFR Section 54.313(e)(2)(i)(A), Attach the document
which contains the community anchor institution details.
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 1 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
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
Page 21
(10005) Rural Digital Opportunity Fund 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>
<10010>
<10011>
<10012b>
<10012a>
<10013>
<10014>
RDOF Capital Expenditures
Starting the first July 1 after receiving support until the July 1 after the recipient's support term has ended, recipients of Rural Digital Opportunity Fund support must submit the total amount of support, if any, the recipient used for capital expenditures in the previous calendar year. This is required by 47 C.F.R. § 54.313(e)(2)(i)(B).
RDOF Available Funds Certification
Please provide a response (either yes or no) to this certification request for any recipient of
Rural Digital Opportunity Fund support that 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 1 after receiving support until
the recipient’s penultimate year of support, as required by required by 47 C.F.R. § 54.313(e)
(2)(ii).
RDOF Community Anchor Institutions
Recipients of Rural Digital Opportunity Fund support must attach a list containing the
number, names, and addresses of community anchor institutions to which the eligible
telecommunications carrier newly began providing access to broadband service in the
preceding calendar year. This filing is required by 47 C.F.R. § 54.313(e)(2)(i)(A).
Please Provide Attachment
Using link, download template and list the number, name and address for each community
anchor institution. As required by 47 CFR Section 54.313(e)(2)(i)(A), Attach the document
which contains the community anchor institution details.
RDOF FCC Form 470 Postings
For the filing due July 1st following full implementation of this requirement, please provide
a response (either yes, no, or not applicable) to this certification request. Recipients of Rural
Digital Opportunity Fund must respond affirmatively that they bid on category one
telecommunications and Internet access services in response to all FCC Form 470 postings
seeking broadband service that meets the connectivity targets for the schools and libraries
universal service support program for eligible schools and libraries (as described in §
54.501) located within any area in a census block where the carrier is receiving Rural Digital
Opportunity Fund, and that such bids were at rates reasonable comparable to rates charged
to eligible schools and libraries in urban areas for Instructions for Completing FCC Form 481
OMB Control No. 3060-0986 (High-Cost) OMB Control No. 3060-0819 (Low-Income)
November 2020 Page 44 comparable offerings. This filing is required by 47 C.F.R. §
54.313(e)(2)(i)(C). This certification will not be required until the July 1st following the E-
Rate program year that this obligation has been fully implemented. Modernizing the E-Rate
Program for Schools and Libraries et al., WC Docket. Nos. 13-184, 10-90, 29 FCC Rcd 15538,
15566-67, para. 72 (2014).
RDOF Post-Final Deployment Milestone Performance Certification
Starting the first July 1st after a Rural Digital Opportunity Fund recipient meets its final
service milestone until the July 1st after the support recipient’s support term has ended,
please provide a response (either yes, no, or not applicable) that the Rural Digital
Opportunity Fund-funded network that the support recipient operated in the prior year
meets the relevant performance requirements in 47 C.F.R. § 54.309. This filing is required by
47 C.F.R. § 54.313(e)(2)(iii).
Name of Attached
Document Listing
Required Information
Page 21
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
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 24
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
Please Provide Waiver Document
Allowable File Type (pdf only)
Name of Attached Document Listing Required
Information
Page 24
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.
I certify that no Federal subsidy made available through a program administered by the Commission that
provides funds to be used for the capital expenditures necessary for the provision of advanced
communications services has been or will be used to purchase, rent, lease, or otherwise obtain, any
covered communications equipment or service, or maintain any covered communications equipment or
service previously purchased, rented, leased, or otherwise obtained, as required by 47 C.F.R. § 54.10.
Please Provide Waiver Document
Allowable File Type (pdf only)
Name of Attached Document Listing Required
Information
Answer yes or no (I am participating in the reimbursement program and the removal, replacement, and
disposal term has not expired) if the reporting ETC does not use covered communications equipment or
services published on the Covered List, as required by 47 C.F.R. Section 54.11
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
IW Form 481 549 2023.pdf
no
I-Wireless, LLC dba Access Wireless
yes
yes
Page 22
Page 22
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:
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.
I understand that making willful false statements in any part of this report and/or in these certifications is
punishable by fine or imprisonment pursuant to 47 U.S.C. Sections 416(c), 503(b)(1)(B), and 18 U.S.C. Section 1001.
Jen Rose
2024
Sean Cullen
CFO
29-06-2023 09:46:28
[e-mail]
479020
479020
2023-06-28
[phone]
4
4
I-Wireless, LLC dba Access Wireless
I-Wireless, LLC dba Access Wireless
2023-07-03
CERTIFIED ONLINE
Attachments
29-06-2023 09:46:28
(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>
NORS
Reference
Number Outage Start
Date
Start
Time
Outage End
Date
End
Time
Customers
Affected
Number of
Customers
Facilities
Affected
(Yes / No)
Service Outage Did This Outage
Affect Multiple
Service Outage Preventative
Outage Outage Number of Total
911
<220>
<220> Upload Service Outage Data
Name of Attached Document
<e>
Below is a preview of the CSV file attached for this section. To view all the data, please select “Full OMB Form with Attachments".
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
<a3>
Doing Business As Company or Brand DesignationAffiliatesSAC
(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>
FCC Form 481
OMB Control No. 3060-0986/OMB Control No. 3060-0819
December 2020
<813> <a1> <a2>
<<<<813>813>813>813>
Name of Attached Document
Upload Operating Company Data
Below is a preview of the CSV file attached for this section. To view all the data, please select “Full OMB Form with Attachments".
Jen Rose
2024
29-06-2023 09:46:28
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
(5005) Alaska Plan Participants
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>
<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
Below is a preview of the CSV file attached for this section. To view all the data, please select “Full OMB Form with Attachments".
<5013>
Name of Attached Document
Upload Backhaul Technology Data
Jen Rose
2024
[e-mail]
479020
[phone]
I-Wireless, LLC dba Access Wireless
(Effective 12/2021)
Lifeline Only
1,000
Unlimited
4.5GB
X
X
X
X
X
X
X
X
X
X
n/a
$9.25
n/a
$0
Purchased Minutes Text 
(SMS/MMS)
$5 Card 250 Unlimited
$10 Card 500 Unlimited
$25 Card Unlimited Unlimited
$35 Card Unlimited Unlimited
$50 Card Unlimited Unlimited
$70 Card Unlimited Unlimited
$110 Card Unlimited Unlimited
*
  X  
  X  
  X  
  X  
  X  
  X  
  X  
  X  
  X  
  X  
i‐wireless, LLC's "Access Wireless" Lifeline Rate Plans 
Combination Lifeline ACP Plans 
Unlimited
Unlimited
15 GB
ACCESS WIRELESS TOP UP CARDS*
$60.00
$9.25
$0
Federal ACP Subsidy $30.00
50 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.
National Plan Voice Minutes 
(non‐rollover)
Text
Data
Additional Airtime
Free SIM or Data‐Capable Device
Local Calls
Nationwide Long Distance
Voicemail, Caller ID, Call Waiting
Free 911
Free 611
Balance Inquiries
Data
Available with purchase of Top Up Card
10 GB
20 GB
Federal Lifeline Subsidy
Lifeline Consumer Price
Text Included
Data Allowance
Participation in Kroger Wireless 
Retail Price
250 MB
500 MB
2 GB
3 GB
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