HomeMy WebLinkAbout20250131Sage Telecom Communications LLC dba TrueConnect Form 555.pdf RECEIVED
nn202NN5nnJanTTuary 31
Annual Lifeline Eligible Telecommunications Carrier Certification Form All carriers must complete all�T PtTo15s of BLIC
all sections Form must be submitted to USAC and filed with the Federal Communications Comr(4WTIE COMMISSION
IMPORTANT: PLEASE READ INSTRUCTIONS FIRST
Deadline:January 31 st(Annually)
479031 143037286
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).
2024 ID Sage Telecom Communications,LLC
Recertification Year State ETC Name
TruConnect TSC Acquisition Corporation
DBA,Marketing,or Other Branding Name Holding Company Name
(!f same as ETC narra,l st'N/A"Do not leave blank) (if same as ETC name,fist'N/A'Do no
I 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
549013 TruConnect Communications, Inc.
549011 TruConnect Communications, Inc.
649009 TruConnect Communications, Inc.
589019 TruConnect Communications, Inc.
169007 TruConnect Communications, Inc.
149015 TruConnect Communications, Inc.
119012 TruConnect Communications, Inc.
299047 TruConnect Communications, Inc.
199037 TruConnect Communications, Inc.
259065 TruConnect Communications, Inc.
519031 TruConnect Communications, Inc.
189043 TruConnect Communications, Inc.
369059 TruConnect Communications, Inc.
159057 TruConnect Communications, Inc.
429062 TruConnect Communications, Inc.
209046 TruConnect Communications, Inc.
269067 TruConnect Communications, Inc.
460001 TruConnect Communications, Inc.
210001 TruConnect Communications, Inc.
480001 TruConnect Communications, Inc.
350001 TruConnect Communications, Inc.
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330001 TruConnect Communications, Inc.
240002 TruConnect Communications, Inc.
550001 TruConnect Communications, Inc.
430001 TruConnect Communications, Inc.
310001 TruConnect Communications, Inc.
280002 TruConnect Communications, Inc.
500001 TruConnect Communications, Inc.
620001 TruConnect Communications, Inc.
370002 TruConnect Communications, Inc.
380003 TruConnect Communications, Inc.
270001 TruConnect Communications, Inc.
400001 TruConnect Communications, Inc.
390001 TruConnect Communications, Inc.
630001 TruConnect Communications, Inc.
520003 TruConnect Communications, Inc.
610001 TruConnect Communications, Inc.
220002 TruConnect Communications, Inc.
320002 TruConnect Communications, Inc.
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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.
1 am an officer of the company named above. I am authorized to make this certification for the SAC listed
above.
Initial DP
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 DP
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 indica to 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 113
February 31
March 37
April 14
May 38
June 45
July 46
August 68
September 23
October 147
November 155
December 77
Total Subscribers 794
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,
Danielle Perry Danielle Perry-Chief Compliance Officer
Signature of Officer Printed Name and Title of Officer
regulatoryaffairs@truconnect.com 01-29-2025
Email Address of Officer Date
Alex Rasor 972-523-1729
Person Completing This Certification Form Contact Phone Number
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