20240201TracFone Wireless Inc Form 555.pdf

TRACF(@)NE"
wireless, inc.
VIA OVERNIGHT MAIL
Jean Jewell, Secretary
Idaho Public Utilities Commission
472 W. Washington St.
Boise, ID 83 720
Re: TracFone Wireless, Inc. -FCC Form 555 Report
Dear Ms. Jewell:
Lcg,d Dcp.irtm~'.111
Stq,hcn A1hans,~n. Senior Attorney -Rq;:ul;ltlir:,·
9700 \I\V 1 l~th A,·.:nuc I /111iami, FL 3317:-:
F-l\1!;1il: ~1cphcn.;1thnn~tin,frwriA1n.co111
January 30, 2024
In accordance with the Federal Communication Commission's Lifeline Reform Order and
47 CFR 54.416{b), please find enclosed a copy of the FCC Form 555 Report ofTracFone
Wireless Inc. {"TracFone"). You may reach me at [phone], or
[e-mail] if you have any questions.
Sincerely,
Stephen Athanson
Regulatory Counsel
www.tracfone.com I www.netlO.com I www.straighttalk.com I www.safelink.com
Annual Lifeline Eligible Telecommunications Carrier Certification Form All carriers must complete all or portions of
all sections Form must be submitted to USAC and flied with the Federal Corrvnunications Commission
IMPORTANT: PLEASE READ INSTRUCTIONS FIRST
Deadline: January 31st (Annually)
479021 143030103
Study Area Code (SAC) Service Provider Identification Number (SPfN)
(An Eligible Telecommunications Carrier (ETC) must provide a certification fonn for each SAC that provides Lifeline service).
2023
Recertification Year
SafeLink Wireless
OBA, Marketing, or Other Branding Name
Ofsemeas ETC name, llst"N/A" Do.ll!!tlHve blank)
ID
State
TracFone Wireless, Inc.
ETC Name
TracFone Wireless Inc
Holding Company Name
Of same as ETC name, llst"N/A' Do.D:Qtleeve blank)
Does the reporting company have affiliated ETCs? Yes·-No X
Provide a list of all ETCs that are afflllated with the reporting ETC, using page 4 and add111onal sheets If necessary. Afflllation shall be detennlned in accordance with Section
3(2) of the Communlca11ons Act That Sec11on defines •afflnate• as 'a person that (directly or lndlreclly) 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 APD
Annual Recertification Results
Report the results of recertiflcatlon 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-8)
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 APD
No Subscribers Certification complete this section if ETC claimed no Lifeline subscribers.
I certify that my company did not ciaim 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
2
ETCs Subject to the Non-Usage Requirements
All ET Cs must complete the appropriate check-box. ET Cs that do not assess and collect a monthly fee from their Lifeline subscribers are subject 1o the
non-usage requirements. ETCs subject1o 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 1o 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 X No_
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 11854
February 4694
March 4407
April 4073
May 4533
June 4169
July 2885
August 2329
September 2682
October 1439
November 1404
December 1593
Total Subscribers 46062
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
partnership agreement), and would typically be president, vice president for operations, vice president for finance,
comptroller, treasurer, or a comparable position. If the flier Is a sole proprietorship, the owner must sign the certification.
Signature Block
3
By signing below, I certify that the infonnation 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,
Alexander Pis-Dudot
Signature of Officer
[e-mail]
Email Address of Officer
Janet Morejon
Person Completing This Certification Fonn
Alexander Pis-Dudot -AVPAccounting
Printed Name and Title of Officer
01-25-2024
Date
305-715-6522
Contact Phone Number