20240130Cable One Inc Form 555.pdf

Cable One
JENAEHECK
Legal Dept.
210 E. Earll Drive
Phoenix, Arizona 85012
PH: 602-364-6092
FAX: [phone]
[e-mail]
January 30, 2024
Monica Barrios-Sanchez
Commission Secretary
Idaho Public Utilities Commission
11331 WChinden Blvd.
Building 8, Suite 201-A
Boise, ID 83714
[e-mail]
Re: Cable One Inc./Cable One VolP LLC; Copy of Form 555 for State of Idaho (2023 Data
Certification) SAG - 479030
Dear Ms. Barrios-Sanchez:
As required by Federal Communications Commission (FCC) Regulations, Cable One is submitting a copy of its
Annual Lifeline Eligible Telecommunications Carrier Certification Form (FCC Form 555) for the State of Idaho.
This Form was recently filed with the FCC in the FCC's Electronic Comment Filing System, Docket 14-171.
If you have any questions, please contact me via email at ienae.heck(a)cableone.biz.
Sincerely,
G3^/Ac^>j?c^
^Jenae Heck
Associate General Counsel
Director of Regulatory Operations
Enclosure
RECEIVED
Tuesday, January 30, 2024 3:20:27 PM
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)

479030 143016933
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 Cable One, Inc.
Recertification Year State ETC Name
Sparklight Cable One, 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 X No
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
421882 Fidelity Telephone LLC
439048 Fidelity Cablevision LLC
429002 Fidelity Cablevision LLC
240523 Hargray Telephone Co., LLC
240512 Bluffton Telephone Company, LLC
220369 ComSouth Telecommunications, LLC
279065 Cable One, Inc.
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 QAT
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 QAT
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 QAT
2
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,

Quynh Tran Quynh Tran - Vice President and Treasurer
Signature of Officer Printed Name and Title of Officer
[e-mail] 01-29-2024
Email Address of Officer Date
Jenae Heck 6023646092
Person Completing This Certification Form Contact Phone Number
3