20240129Viasat Carrier Services Inc Form 555.pdf

Marsha A. Pokorny
Senior Managing Consultant on behalf of Viasat Carrier
Services, Inc.
January 29, 2024
Idaho Public Utilities Commission
Jan Noriyuki, Commission Secretary
11331 W. Chinden Blvd.
Building 8, Suite 201-A
Boise, ID 83714
RE: Viasat Carrier Services, Inc. - Case No. GNR-T-24-0 1
2024 FCC F orm 555 - Annual Lifeline El igible Telecommunications Carrier Certification - Idaho
Dear Staff,
Pursuant to FCC requirements under 47 C.F.R. § 54.416, enclosed please find for filing
in the above referenced Case a copy of Viasat Carrier Services, Inc.'s FCC Form 555 -
Annual Lifeline Eligible Telecommunications Carrier Certification.
If you have any questions regarding this filing, please contact me at [phone] or
[e-mail].
Respectfully Submitted,
RECEIVED
Monday, January 29, 2024 10:16:47 AM
IDAHO PUBLIC
UTILITIES COMMISSION
Annual Lifeline Eligible Telecommunications Carrier Certification Form All carriers must complete all or portions of
all sections Form must be submitted to USAC and filed with the Federal Communications Commission
IMPORTANT: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 31st (Annually)

479026 143051764
Study Area Code (SAC)Service Provider Identification Number (SPIN)
(An Eligible Telecommunications Carrier (ETC) must provide a certification form for each SAC that provides Lifeline service).
2023 ID Viasat Carrier Services, Inc.
Recertification Year State ETC Name
ViaSat, Inc.
DBA, Marketing, or Other Branding Name
(If same as ETC name, list “N/A” Do not leave blank)
Holding Company Name
(If same as ETC name, list “N/A” Do not leave blank)

Does the reporting company have affiliated ETCs? Yes No X
Provide a list of all ETCs that are affiliated with the reporting ETC, using page 4 and additional sheets if necessary. Affiliation shall be determined in accordance with Section
3(2) of the Communications Act. That Section defines “affiliate” as “a person that (directly or indirectly) owns or controls, is owned or controlled by, or is under common
ownership or control with, another person.” 47 U.S.C. § 153(2). See also 47 C.F.R. § 76.1200.

Affiliated ETC’s SAC Affiliated ETC’s Name
1
Initial Certification All ETCs must complete this section.
I certify that the company listed above:
•Has policies and procedures in place to ensure that its Lifeline subscribers are eligible to receive Lifeline
services; and
•Is in compliance with all federal Lifeline certification procedures; and
•Is in compliance with the minimum service levels set forth in 47 C.F.R. § 54.408.
I am an officer of the company named above. I am authorized to make this certification for the SAC listed
above.
Initial RB
Annual Recertification Results
Report the results of recertification efforts for the current calendar year.
Do not leave blocks empty. If the National Verifier is responsible for conducting recertification, enter zero for blocks A - F. If the state Lifeline
Administrator is responsible for conducting recertification, report the results for each block.

A. Subscribers eligible for recertification within current calendar year
B. Subscribers de-enrolled prior to recertification attempts
C. Total number of subscribers required to be recertified (A-B)
D. Subscribers successfully recertified
E. Subscribers de-enrolled for failed recertification
F. Percentage de-enrolled for failed recertification (E/C)
I certify that the company listed above has procedures in place to recertify consumer eligibility by relying upon
notice of eligibility from: state Lifeline administrator X National Verifier
I am an officer of the company named above. I am authorized to make this certification for the SAC listed
above.
Initial RB
No Subscribers Certification Complete this section if ETC claimed no Lifeline subscribers.
I certify that my company did not claim federal low income support 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(s) listed on this form
Initial
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ETCs Subject to the Non-Usage Requirements
All ETCs must complete the appropriate check-box. ETCs that do not assess and collect a monthly fee from their Lifeline subscribers are subject to the
non-usage requirements. ETCs subject to the non-usage requirements must indicate the number of subscribers de-enrolled by month. ETCs that only
assess a fee but do not collect such fees are subject to the non-usage requirements and must also indicate the number of subscribers de-enrolled by
month.

Is the ETC subject to the non-usage requirements? Yes No X
If yes, record the number of subscribers de-enrolled for non-usage by month in Block H below.

G H
Month Subscribers De-Enrolled for Non-Usage
January
February
March
April
May
June
July
August
September
October
November
December
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 similar legal document. An officer is a person who occupies a position specified in the corporate by-laws (or
partnership 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.
Signature Block
By signing below, I certify that the information provided is true and accurate. I am an officer of the company named
above. I am authorized to make this certification for this SAC.

Signed,

Robert Blair Robert Blair - President and Secretary
Signature of Officer Printed Name and Title of Officer
[e-mail] 01-22-2024
Email Address of Officer Date
Robert Blair 855-463-9333
Person Completing This Certification Form Contact Phone Number
3