20250708AirVoice Wireless ETC Affidavit.pdf

RECEIVED
July 08, 2025
IDAHO PUBLIC
UTILITIES COMMISSION
State of Florida ) CERTIFICATION BY ELIGIBLE TELECOMMUNICATIONS CARRIER
) ss OF COMPLIANCE WITH SERVICE QUALITY AND CUSTOMER
County of Orange ) PROTECTION, ABILITY TO REMAIN FUNCTIONAL IN EMERGENCIES,
AND USE OF FEDERAL HIGH-COST SUPPORT.
AFFIDAVIT OF BUSINESS OR CORPORATE OFFICER
The Idaho Public Utilities Commission Order No. 29841 requires that Eligible Telecommunications Carriers
(ETC) certify that it is compliant with applicable service quality standards and consumer protection rules; and
ETCs must demonstrate the ability to remain functional in emergencies. In addition, the Commission must file
an annual certification with the USAC and the FCC that all federal high-cost support provided to ETCs within
the State of Idaho will be used only for the provision, maintenance, and upgrading of facilities and services for
which the support is intended. Accordingly, the undersigned states and verifies under oath the following:
AIR VOICE
1 WIRELESS, LLC dba
I am an officer of AirTalk Wireless an eligible telecommunications carrier for receiving federal
universal service support under section 214(e) of the Telecommunications Act of 1996 in the state of
Idaho.
2. 1 am familiar with the Company's day-to-day operations in the state of Idaho and with the State's
service quality standards and consumer protection rules as set forth in Commission Order No. 29841.
AIR VOICE
3. WIRELESS, LLC dba
AirTalk Wireless is complying with applicable service quality standards and consumer
protection rules of the Federal Communications Commission and the Idaho Public Utilities
Commission.
4. I certify to the Commission that the Company is able to remain functional in emergencies as set forth in
Commission Order No. 29841 and in 47 C.F.R. § 54.201(a)(2).
AIR VOICE
WIRELESS, LLC
5. 1 also certify that all federal universal service support funds received by dba AirTalk Wireless during
the current calendar year will be used in a manner consistent with section 254(e); that is, for the
provision, maintenance, and upgrading of facilities and services for which the support is intended. The
company will continue to comply for the period of January 1, 2026 ,through December 31, 2026 to be
eligible for federal universal service fund support.
6. This verification and affidavit is provided to be the Idaho Public Utilities Commission to enable the IPUC
to certify to the FCC that federal universal service support received by the eligible carriers in the state
will be used in a manner consistent with Section 254(e) of the Telecommunications Act.
Henry Hung Do
CEO
Name/Title
g Date
U C I to before e this U day of
;��jiY"a�•.., KAYLA COLON
?r°• Notary Public-State of Florida
s� Commission#HH 598342
•'.?2,oF�c1�' My Comm.Expires Oct 1,2028
bonded through National Notary As jNory Publicfor u,�, B residing at-T_",,,7
ommission expires G

Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Filing Type and Contact Info
Filing Type
This information has been preselected based on High Cost and Lifeline program support paid out in the previous
calendar year. If you think the filing type is incorrect,please contact USAC.
❑High Cost(Section 54.313)
m Lifeline(Section 54.422)
Contact Information
Include contact information for the person best able to answer questions about this form.
Contact Name(030)
Octavia Clanton
Phone#(035) Ext.(Optional)
[phone]
Contact Email Address(039)
[e-mail]
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Service Outage Reporting (Voice) (200)
Reportable Outages
For the prior calendar year,were there any reportable voice service outages?(210)
O Yes O No
Upload Service Outage Data (220)
Service Outage Data Template
CSV only
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Number of Complaints per 1,000 Customers (400)
Report Voice Complaints
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.(400)
Enter complaints per 1000 customers for fixed voice(410)
Enter complaints per 1000 customers for mobile voice(420)
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Compliance with Service Quality Standards and Consumer Protection
Rules (500)
Certify
Compliance with Minimum Service Standards(515)
Does the carrier comply with applicable minimum service standards?
O Yes Q No
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Functionality in Emergency Situations (600)
Certify
Functionality in Emergency Situations Certification(600)
Is the carrier able to function in emergency situations?
O Yes O No
Descriptive Document for Functionality in Emergency Situations(610)
PDF only
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Operating Companies (800)
Carrier Names
Validate the information listed above(811)by selecting one of the following:
O Holding Company/Affiliate name listed above is correct.(811 A)
O Holding Company/Affiliate name listed above is NOT correct.(811 B)
The correct Holding Company/Affiliate name is(811C):
O This study area does not have a Holding Company/Affiliate name. (811 D)
Operating Company
Operating Company(812)
Upload Operating Company Data(813A,813B,813C)(Optional)
Operating Company Data Template
CSV only
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Tribal Lands Reporting (900)
Tribal Land Services
Does the filing entity offer Tribal land services?(900)
O Yes O No
Tribal Land(s)on which ETC Serves(910)
Tribal Government Engagement Obligation(920)
PDF only
Confirm Statuses
Select Yes, No,or NA for each of the below to confirm the status described on the attached PDF(920)demonstrates
coordination with the Tribal government pursuant to Section 54.313(a)(5)includes:
Needs assessment and deployment planning with a focus on Tribal community anchor institutions(921)
O Yes O No O NA
Feasibility and sustainability planning(922)
O Yes O No O NA
Marketing services in a culturally sensitive manner(923)
0 Yes O No O NA
Compliance with Rights of way processes(924)
0 Yes O No O NA
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498 ID:143037108 Program Year:2026
Compliance with Land Use permitting requirements(925)
O Yes O No O NA
Compliance with Facilities Siting rules(926)
O Yes O No O NA
Compliance with Environmental Review processes(927)
O Yes O No O NA
Compliance with Cultural Preservation review processes(928)
O Yes O No O NA
Compliance with Tribal Business and Licensing requirements(929)
O Yes O No O NA
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Voice and Broadband Service Rate Comparability (1000)
Certify Voice
Voice Services Rate Comparability Certification(1000)
Is the carrier's pricing of fixed voice services no more than two standard deviations above the applicable national
average urban rate for voice service?If you answer No to line 1000, please provide an explanation for non-
compliance.
O Yes O No O Not Applicable
Attach Detailed Description for Voice Services Rate Comparability Compliance(1010)
PDF,XLS,XLSX only
Certify Broadband
Broadband Comparability Certification(1020)
Does the carrier's broadband services pricing meet one of the following criteria?If you answer No to line 1020,
please provide an explanation for non-compliance.
0 Yes-Pricing is no more than the most recent applicable benchmark announced by the Wireline Competition
Bureau.
O Yes-Pricing is no more than the non-promotional price charged for a comparable fixed wireline service in urban
areas in the states or U.S.Territories where the eligible telecommunications carrier receives support.
O No-Unable to certify broadband rate comparability
0 Not Applicable.
0 Yes-CETC Alaska Plan participant certifies that one plan it offers is substantially similar to a service plan offered
by at least one mobile wireless service provider in the cellular market area of Anchorage,Alaska and offered for the
same or a lower rate than the matching plan in the cellular market area.
Attach Detailed Description for Broadband Rate Comparability Compliance(1030)
PDF,XLS,XLSX only
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Terrestrial Backhaul Reporting (1100)
Certify
Terrestrial Backhaul Certification(1100)
Do terrestrial backhaul options exist?
O Yes O No
Select the appropriate response to confirm the reporting carrier offers broadband service of at least 1 Mbps
downstream and 256 kbps upstream within the supported area pursuant to Section 54.313(g)(1130)
O Yes O No O Not Applicable
Alaska Plan Satellite Backhaul Certification(1140)
Is the carrier providing service consistent with its approved performance plan in the portion(s)of its study area that
relies exclusively on satellite backhaul?
O Yes O No O Not Applicable
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
StateAD OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498 ID:143037108 Program Pear:2026
Lifeline Terms and Conditions (1200)
Upload Document or Link Website
Upload a descriptive documents)AND/OR reference a specific link to your company's website.
Terms&Conditions of Voice Telephony Lifeline Plans(1210)
PDF only
AND/OR
Link to Public Website(1220)
�ftps:/IairtaIkwireless.com/my-state/idaho
Confirm Information
Check these boxes below to confirm that the attached PDF,on line 1210,or the Website listed,on line 1220,contains
the required information pursuant to Section 54.422(a)(2)annual reporting for ETCs receiving low-income support,
carriers must annually report:
0 Information describing the terms and conditions of any voice telephony service plans offered to Lifeline subscribers
(1221)
0 Details on the number of minutes provided as part of the plan(1222)
0 Additional charges for toll calls,and rates for each such plan(1223)
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Price Cap Data (2005)
Certify
Select the appropriate responses below to note compliance as a recipient of frozen High Cost support, High Cost
support to offset access charge reductions,and Connect America Phase II support as set forth in 47 CFR 54.313(c),
(d),(e).The information reported on this form and in the documents attached below is accurate.
Price Cap Carrier Receiving Frozen Support Certification(2015)
Does the carrier certify compliance with the requirements in 47 CFR Section 54.312(a)?
O Yes O No O NA
Price Cap Carrier Connect Am erica ICC Support(2016)
Does the carrier certify compliance with the requirements in 47 CFR Section 54.313(d)?
O Yes O No O NA
Connect America Phase II Reporting 47 CFR Section 54.313(e)(2017A)
Are you a Connect America Fund Phase II recipient?
O Yes O No
Enter total amount of Phase II support,if any,that the price cap carrier used for capital expenditures in 2024.
(2017C)
Price Cap Community Anchor Institutions(2018A)
Indicate if the carrier newly deployed broadband service to community anchor institution(s)in the previous calendar
year.
O Yes-Attach New Community Anchors
O No-No New Community Anchors
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498 ID:143037108 Program Year:2026
O Not Applicable-No Attachment Required
Please Provide Attachment(2018B)
Attach a document to this line to provide the number, names and addresses of community anchor institutions to
which the recipient newly began providing access to broadband service in the preceding calendar year.
Community Anchor Template
XLSM only
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Rate of Return Data (3005)
Certify
Select from the drop down menus 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). 1 further
certify that the information reported on this form and in the documents attached below is accurate.
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?(3007)
O Yes O No
Name of Consultant(3007A) Name of Consultant Firm/Third Party(3007B)
Certification of Public Interest Obligations(3010A)
Does the carrier certify compliance with the requirements in 47 CFR Sections 54.313(f)(1)(i)?
O Yes-Attach Explanation O No-Attach Explanation
O Not Applicable-No Attachment Required
Please Provide Attachment(3010B)
PDF,XLS,XLSX, DOC, DOCX only
Rate-of-Return Community Anchor Institutions(3012A)
Indicate if the carrier newly deployed broadband service to community anchor institution(s)in the previous calendar
year.
O Yes-Attach New Community Anchors O No-No New Community Anchors
O Not Applicable-No Attachment Required
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498 ID:143037108 Program Year:2026
Please Provide Attachment(3012B)
Using link,download template and list the number, name and address for each community anchor institution.As
required by 47 CFR Section 54.313(f)(1)(ii),attach the document which contains the community anchor institution
details.
Community Anchor Template
XLSM only
As defined in 47 CFR Section 54.313(f)(2),is your company a Privately Held ROR Carrier?(3013)
O Yes O No
Does your company file the RUS annual report?(3014)
O Yes O No
Please check these boxes to confirm that the attached document(s),on line 3017,contains the required
information pursuant to Section 54.313(f)(2)compliance requires:
❑Electronic copy of their annual RUS reports(Operating Report for Telecommunications Borrowers)(3015)
❑Document(s)with Balance Sheet,Income Statement and Statement of Cash Flows(3016)
Annual Report(3017)
false
PDF,XLS,XLSX, DOC, DOCX only
Is your company audited?(3018)
O Yes O No
If the response is yes or no on line 3018,please check the boxes below to confirm your submission on line
3026 pursuant to Section 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(3019)
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
StateAD OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498 ID:143037108 Program Pear:2026
❑Document(s)with Balance Sheet,Income Statement and Statement of Cash Flows(3020)
❑Management letter and/or audit opinion issued by the independent certified public accountant that performed the
company's financial audit(3021)
❑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(3022)
❑Underlying information subjected to a review by an independent certified public accountant(3023)
❑Underlying information subjected to an officer certification(3024)
❑Document(s)with Balance Sheet,Income Statement and Statement of Cash Flows(3025)
Worksheet Listing(3026)
PDF,XLS,XLSX, DOC, DOCX only
Financial Data Summary
Enter the specified financial data below which is located on your RUS Report(attached on Line 3017)or your
reviewed/audited financial statements(attached on Line 3026).
Revenue(3027)
Operating Expenses(3028)
Net Income(3029)
Telephone Plant In Service(TPIS)(3030)
Total Assets(3031)
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
StateAD OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498 ID:143037108 Program Pear:2026
I I
Total Debt(3032)
Total Equity(3033)
Dividends(3034)
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Rural Broadband Experiment Data (4005)
Certify
Public Interest Obligations(4001)
Per FCC 14-98(paragraphs 26-29 and 78), 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.
O Yes O No
RBE Community Anchor Institutions(4003A)
Indicate if the carrier newly deployed broadband service to community anchor institution(s)in the previous calendar
year.
O Yes-Attach New Community Anchors O No-No New Community Anchors
Please Provide Attachment(4003B)
Using link,download template and list the number,name and address for each community anchor institution.As
required by FCC 14-98(paragraph 79),attach the document which contains the community anchor institution details.
Community Anchor Template
XLSM only
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Alaska Plan Participants (5005)
Certify Terrestrial Backhaul
Newly Available Terrestrial or other Satellite Backhaul(RoR Carriers)(5011)
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.
O Yes O No
Newly Available Terrestrial or other Satellite Backhaul(CETC Carriers)(5012)
If the filing carrier identified in its approved performance plans that it relies exclusively on satellite backhaul for a
certain portion of the population in its service area, indicate whether any terrestrial backhaul or other satellite
backhaul became commercially available in the previous calendar year in areas that were previously served
exclusively by satellite backhaul.
O Yes O No
Upload Backhaul Technology Data(5013A-5013C)
Backhaul Data Template
CSV only
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Phase II Auction Reporting (6005)
Certify
Enter the total amount of Phase II Auction Support,if any,the carrier used for capital expenditures.(6010)
Phase II Auction and New York Funds Certification(6011)
Certify 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.
0 Yes 0 No
Community Anchor Institutions(6012a)
Indicate if the carrier newly deployed broadband service to community anchor institution(s)in the previous calendar
year.
0 Yes-Attach New Community Anchor 0 No-No New Community Anchor
Using the template,upload a document with a number,name and address for each community anchor
institution.(6012b)
Community Anchor Template
XLSM only
FCC Form 470 Postings(6013)
For the filing due July 1 following full implementation of this requirement answer this certification request.
0 Yes 0 No 0 Not Applicable
Post-Final Deployment Milestone Performance Certification(6014)
Starting the first July 1 after meeting the final service milestone,certify that the Phase ll-funded networkthat the
Phase 11 auction recipient operated in the prior year meets the relevant performance requirements in Section 54.309.
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
StateAD OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498 ID:143037108 Program Year:2026
O Yes 0 No O Not Applicable
Page 21 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Phase-Down Support Reporting (7005)
Certify
Price Cap Carrier and Fixed Competitive Eligible Telecommunications Carrier Transitional Support
Requirement Certification.(7010)
This certification request applies to any price cap carrier or fixed competitive eligible telecommunications carrier that
elects to continue receiving support pursuant to Section 54.312(d)or Section 54.307(e)(2)(iii)starting July 1,2020,
and annually thereafter on July 1 for each subsequent year they receive such support.These carriers must use this
support throughout specific high-cost and extremely high-cost census blocks where they continue to have the federal
high-cost ETC obligation to provide voice service pursuant to Section 54.201(d)at rates that are reasonably
comparable to comparable offerings in urban areas. Per Section 54.313(m),does the carrier certify that they used all
such support received in the previous year to provide voice service in compliance with the above obligation?
O Yes O No
Page 22 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Puerto Rico Fixed and Mobile Funds Certification (8005)
Certify Fixed
Capital Expenditures(8010)
Enter the total amount of Uniendo a Puerto Rico Stage 2 fixed support, if any,the carrier used for capital
expenditures.
Available Funds Certification(8011)
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.
O Yes O No
Community Anchor Institutions(8012A)
Indicate if the carrier newly deployed broadband service to community anchor institution(s)in the previous calendar
year.
O Yes-Attach New Community Anchors O No-No New Community Anchors
Please Provide Attachment(8012B)
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.
Community Anchor Template
XLSM only
FCC Form 470 Postings(8013)
For the filing due July 1 following full implementation of this requirement answer yes, no,or not applicable to this
certification request.
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
O Yes O No O Not Applicable
Post-Final Deployment Milestone Performance Certification(8014)
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 Section 54.309.
O Yes O No O Not Applicable
Support Reimbursement Certification(8020)
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.
O Yes O No
Disaster Preparedness and Response Documentation(8030)
54.313(n):Recipients of foxed 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.
O Yes O No
Certify Mobile
Support Reimbursement(8040)
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.
O Yes O No
Disaster Preparedness and Response Documentation(8050)
Page 24 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
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.
O Yes O No
Mobile Disbursements Certification(8060)
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.
O Yes O No
Transitional Support(8070)
Recipients of transitional support under Section 54.1516 shall certify that such support was not used for costs that
are or will be reimbursed by other sources of support,or expenses not directly related to network restoration,
hardening,and expansion consistent with the framework of the Uniendo a Puerto Rico Fund.Transitional support
recipients shall certify that they have conducted an annual review to determine that their disaster preparation and
recovery documentation is up to date,as required by Section 54.1515(a)through(c)or Section 54.1524.Answer yes
or no if carrier is compliant with 54.313(q).
O Yes O No
Spending Plans for Recipients of Legacy Frozen Phase-Down Support(8080)
For annual reports due in 2024,2025,and 2026, recipients of frozen high-cost support under Section 54.1504(b)
shall certify that such support received after June 1,2023 was used for resiliency and redundancy measures and to
maintain their voice and broadband network footprint.
O Yes O No
Page 25 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Connect USVI Fixed and Mobile Funds Certification (9005)
Certify Fixed
Capital Expenditures(9010)
Enter the total amount of Connect USVI Fund Stage 2 fixed support, if any,the carrier used for capital expenditures.
Available Funds Certification(9011)
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.
O Yes O No
Community Anchor Institutions(9012A)
Indicate if the carrier newly deployed broadband service to community anchor institution(s)in the previous calendar
year.
O Yes-Attach New Community Anchors O No-No New Community Anchors
Please Provide Attachment(9012B)
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.
Community Anchor Template
XLSM only
FCC Form 470 Postings(9013)
For the filing due July 1 following full implementation of this requirement answer yes, no,or not applicable to this
certification request.
Page 26 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
O Yes O No O Not Applicable
Post-Final Deployment Milestone Performance Certification(9014)
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 Section 54.309.
O Yes O No O Not Applicable
Support Reimbursement Certification(9020)
54.313: 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.
O Yes O No
Disaster Preparedness and Response Documentation(9030)
54.313: 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.
O Yes O No
Certify Mobile
Support Reimbursement(9040)
54.313: Recipients of Connect USVI Fund Stage 2 mobile support shall cer&y 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
O Yes O No
Disaster Preparedness and Response Documentation(9050)
Page 27 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
54.313: 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.
O Yes O No
Mobile Disbursements Certification(9060)
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.
O Yes O No
Transitional Support(9070)
Recipients of transitional support under Section 54.1516 shall certify that such support was not used for costs that
are or will be reimbursed by other sources of support,or expenses not directly related to network restoration,
hardening,and expansion consistent with the framework of the Connect USVI Fund.Transitional support recipients
shall certify that they have conducted an annual review to determine that their disaster preparation and recovery
documentation is up to date,as required by Section 54.1515(a)through(c)or Section 54.1524.Answer yes or no if
carrier is compliant with 54.313(q).
O Yes O No
Spending Plans for Recipients of Legacy Frozen Phase-Down Support(9080)
For annual reports due in 2024,2025,and 2026, recipients of frozen high-cost support under Section 54.1504(b)
shall certify that such support received after June 1,2023 was used for resiliency and redundancy measures and to
maintain their voice and broadband network footprint.
O Yes O No
Page 28 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Rural Digital Opportunity Fund Reporting (10005)
Certify RDOF
Capital Expenditures(10010)
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.Section 54.313(e)(2)(i)(B).
Available Funds Certification(10011)
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 vAll 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 recipients penultimate year of support,as required by required by 47 C.F.R.Section 54.313(e)(2)(i).
O Yes O No
Community Anchor Institutions(10012A)
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.Section 54.313(e)(2)(i)(A).
O Yes-Attach New Community Anchors O No-No New Community Anchors
Please Provide Attachment(10012B)
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.
Community Anchor Template
XLSM only
Page 29 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498 ID:143037108 Program Year:2026
FCC Form 470 Postings(10013)
For the filing due July 1 st 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 Section 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.Section 54.313(e)(2)(i)(C).This
certification vAll 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).
O Yes O No O Not Applicable
Post-Final Deployment Milestone Performance Certification(10014)
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.Section 54.309.This filing is required by 47 C.F.R.Section 54.313(e)
(2)(i ii).
O Yes O No O Not Applicable
Page 30 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Enhanced ACAM (E-ACAM) Certification (11005)
Certify Enhanced A-CAM
BEAD Program Challenge Processes Certification(11010)
Certify(yes or no)that,in the previous calendar year,the carrier participated in good faith in any relevant BEAD
Program challenge processes or other processes conducted by states or other BEAD Program eligible entities to
determine the eligibility of locations for the BEAD Program,and that they otherwise coordinated vAth states,Tribes,
and other eligible entities to help avoid duplicative federal broadband funding.
O Yes O No
BEAD Program Funding Certification(11020)
Certify(yes or no)that,in the previous calendar year,the carrier complied with the obligation not to receive or use
BEAD Program or other future federal grant funding, unless otherwise specified by the Commission or Bureau,that
supports broadband deployment for those locations for which they are receiving Enhanced A-CAM support.
O Yes O No
Affordable Connectivity Program Certification(11030)
Certify(yes or no)that,in the previous calendar year,the carrier continued to participate in the Affordable
Connectivity Program or any substantially similar successor program,as required by the terms of your Enhanced A-
CAM offer(s).
O Yes O No
Descriptive docu ment for Affordable Connectivity Program Certification(11031)
In the uploaded file,describe how the carrier continued to participate in the Affordable Connectivity Program or any
substantially similar successor program,as required by the terms of your Enhanced A-CAM offer(s).
PDF Only
Cybersecurity and Supply Chain Risk Management Plans Certification(11040)
Recipient certifies that, in the prior year, it has maintained its cybersecurity and supply chain risk management plans
pursuant to 47 CFR Section 54.308(g).
Page 31 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
0 Yes 0 No
Cybersecurity and Supply Chain Risk Management Plans Substantive Modification(11041)
Recipient filed a substantive modification to its cybersecurity and/or supply chain risk management plans in the prior
year, pursuant to 47 CFR Section 54.308(g)(6).
0 Yes O No
Cybersecurity and Supply Chain Risk Management Plans Substantive Modification Date(11042)
Report the most recent date that the recipient filed any substantive modifications to its cybersecurity and/or supply
chain risk management plans.
Page 32 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498ID:143037108 Program Year:2026
Certifications
Supply Chain Certifications
Section 54.9: Prohibition on the Use of Funds
I certify under penalty of perjury that no universal service support has been or will be used to purchase,obtain,
maintain, improve,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.
If No is selected,a waiver is required for each SAC which is not certified.
O Yes O No
Upload Waiver Document
PDF only
Section 54.10: Prohibition on the Use of Certain Federal Subsidies
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,
otherwise obtained,as required by 47 C.F.R.Section 54.10.
If No is selected,a waiver is required for each SAC which is not certified.
O Yes O No
Upload Waiver Document
PDF only
Section 54.11: Requirements to Remove and Replace
Prior to answering,review section 54.11 of the Commission's rules(47 CFR Section 54.11).Answer Yes if either(1)
you comply with section 54.11(a),meaning you do not use covered communications equipment or services,or(2)
Page 33 of 34
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Privileged and Contains Confidential Information
AirVoice Wireless,LLC FCC Form 481
State:ID OMB Control#:3060-0986(High Cost)&
SAC:479032 3060-0819(Low Income),December 2020
498 ID:143037108 Program Year:2026
section 54.11(d)applies to you, meaning you are not yet subject to section 54.11(a)because you are a
Reimbursement Program recipient with an unexpired removal, replacement,and disposal term per section 1.50004
(h)of the Commission's rules(47 CFR Section 1.50004(h)).Answer No if you do not comply with section 54.11(a),
meaning you do use covered communications equipment or services.
O Yes O No
Accuracy Certifications
Certify
01 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.
01 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.
Signature
Officer Name
octavia clanton
Title
compliance associate
Received Date
025-07-02
01 understand this is a digital signature,and is the same as if I signed my name with a pen.
Page 34 of 34
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