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ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data...

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FCC Form 481 ·Carrier Annu1I Reportln1 Data Collection Form <010> Study Area Code <015> Study Area Name <020> Program Year <030> Contact Name: Person USAC should contact with questions about this data <035> Contact Telephone Number: Number ol the person ldentilied In data line <030> <039> Contact Email Address: 119021 Aaalat Wlrelea1 U.C 2016 4072601011 oxt . Email 01 the person ident1tied In data line <030> regulator:yec1 I longwood. coa ANNUAL REPORTING FOR AU CARRIERS <100> Service Quality Improvement Report ing <200> <210> <300> <310> Outage Reporting (voicer-) ___ .., I ./ ij <- check box If no outages to report :'.:,"' T' I I (comp/tt• worhhttf) suu 54.422 COmpletlon COmpletlon Reaulred Reaulred (chtdl. box wllm comp/.,•} \ ,m I <320> Unfulfllled Service Requests (bro,;a.:d.:ba:.:n.:.:d:.:.l __ ..:::=====L------ ----. <330> o"""" An•mP<> fbm•""'' I .. , <400> Number of Complaints per 1,000 customers (voice) <410> Fixed I 0 <420> Moblle <430> Number of Complaints per 1,000 customers (broadband <440> Fixed <450> Mobile <SOO> Service Quality Standards & Consumer Protection Rules Compliance Mahe ll lrele .. _Fcc 41l_Sectlon 510,pd! <510> <600> Functionali In Emer enc Situations Au let llire leH_PCC 41l _SecLlon 610 .p<lf <610> <700> Company Price O erlngs voice <710> Company Price Offerings (broadband) <800> Operating Companies and Affiliates <900> Tribal Land Offerings (Y/N)? Q Q <1000> Voice Services Rate Comparabili ty Certification <1010> /chtck 10 lndl<ot< ctnl/Tcat/OIO} /comp/«• onocltd-11"""1 (comp/.«• ottadtd wiotllbnt,} /comp/c<•onod><d-'IN") '""'p/"'• onoch<d woilcSht«) (01rodt dt1cr{pd'H: documtt1r} <1100> Certify whether terrestrial backhaul options exist (Yes or No) Q Q l•l•o<. cll«kro1"'11<o,. .. ,,,fl<m""'/ <1110> (compl.,•ottodtd-lcSho"') <1200> Terms and Condi t ion for li feline Customers /compl .. •ottodtd-t.h- 1 Price Cap Car riers, to Price Cap Additional Documentation Worksheet Including Rare-of-Return Carriers offilioted with Price Cop Loco/ Exchange Carriers <2000> (dt«:k tolndJC.ot* caU/ICOflolt} <200$> /comp/"'• ottoch.d wort.hon) <3000> <3005> Rate of Return Ca rriers, Proceed t o ROR Additional Documentation Worksheet (child fo lndlcrlC« attac.hrd worbhufl II " II " II .... _ __ ..... 11.___.;...t _ _, L--1 - " --' Page Page 1
Transcript
Page 1: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

FCC Form 481 ·Carrier Annu1I Reportln1 Data Collection Form

<010> Study Area Code

<015> Study Area Name

<020> Program Year

<030> Contact Name: Person USAC should contact with questions about this data

<035> Contact Telephone Number: Number ol the person ldentilied In data line <030>

<039> Contact Email Address:

119021

Aaalat Wlrelea1 U.C

2016

4072601011 oxt .

Email 01 the person ident1tied In data line <030> regulator:yec1 I longwood. coa

ANNUAL REPORTING FOR AU CARRIERS

<100> Service Quality Improvement Report ing

<200>

<210>

<300>

<310>

Outage Reporting (voicer-) ___ ..,

I ./ ij<- check box If no outages to report

~:::,::·:.:::: :'.:,"' T' I I

(comp/tt• octodt~d worhhttf)

suu 54.422

COmpletlon COmpletlon Reaulred Reaulred (chtdl. box wllm comp/.,•} \ ,m

I l~'N

<320> Unfulfllled Service Requests (bro,;a.:d.:ba:.:n.:.:d:.:.l __ ..:::=====L----------.

<330> o"""" An•mP<> fbm•""''I I'~-··-!. .. , I~

<400> Number of Complaints per 1,000 customers (voice)

<410> Fixed Io· 0

<420> Moblle ~0:.:0:::::::::::::~ <430> Number of Complaints per 1,000 customers (broadband <440> Fixed <450> Mobile <SOO> Service Quality Standards & Consumer Protection Rules Compliance

Mahe ll lrele .. _Fcc 41l_Sectlon 510,pd!

<510>

<600> Functionali In Emer enc Situations Au let llire leH_PCC 41l_SecLlon 610 .p<lf

<610>

<700> Company Price O erlngs voice

<710> Company Price Offerings (broadband)

<800> Operating Companies and Affiliates <900> Tribal Land Offerings (Y/N)? Q Q <1000> Voice Services Rate Comparability Certification

<1010>

/chtck 10 lndl<ot< ctnl/Tcat/OIO}

/comp/«• onocltd-11"""1

(comp/.«• ottadtd wiotllbnt,}

/comp/c<•onod><d-'IN")

/If~ '""'p/"'• onoch<d woilcSht«)

(01rodt dt1cr{pd'H: documtt1r}

<1100> Certify whether terrestrial backhaul options exist (Yes or No) Q Q l•l•o<. cll«kro1"'11<o,. .. ,,,fl<m""'/

<1110> (compl.,•ottodtd-lcSho"')

<1200> Terms and Condit ion for lifeline Customers /compl .. •ottodtd-t.h-1

Price Cap Carriers, Proc~ed to Price Cap Additional Documentation Worksheet

Including Rare-of-Return Carriers offilioted with Price Cop Loco/ Exchange Carriers <2000> (dt«:k tolndJC.ot* caU/ICOflolt}

<200$> /comp/"'• ottoch.d wort.hon)

<3000> <3005>

Rate of Return Carriers, Proceed to ROR Additional Documentation Worksheet (child fo lndlcrlC« c~tti/kotkHt/

(comp/et~ attac.hrd worbhufl

II " I~

II "

II

...._ __ ..... 11.___.;...t _ _,

'----~' L--1 - " --'

Page

Page 1

Page 2: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

(100) Service ~hty 1miwoveme1lt R~portlnc

Data Collealon Fo<m

<010> Stud Area Code

<01.S> Study ATH Name

<020'> Proerom Year

<030> Contact Name· Person US.AC shouJd cont.Jct rtprdlnf tkls dat•

<035> Coni.tl Tt lephon! Numbor · Number of person ldtn~tltd Jn d1~ line <030>

<039> Contxt Em• U Address· Em.II Addre.s.s oJ perton Identified fn d1tA lint <030>

<110> Hu your com n recetved Its ETC certifiatfon from Uit FCC?

Jfyour 1nswer to l ine <110> Is ye" do you hove an U iltln& §54.202(1) •5 <111> yHr plan• filed whh 1ho FCC?

If your 1ruwer to Une <111> fs VH, th.en you ire required to me a protreu repon, on bne <112> deUnnllna the Jl•t\" of your compon'f'• u mina § 54.202(• ) "5 yHr pl1n• on Ide wilh the FCC. 11 Jt rel>1u to your provision of YO«e telephony M~e

<Ul> Att:.ch Ftvll'*YHr S.tv1<• Quahty Improvement Plan or, In 1ub14quent ~~.rt,

IHOlJ

,.,,

t OUUlOH Ut. .

your annual p.rocrtss report f1le.d pursuant to 47 C.F.R. t $4.313(a)(l). tf 'f'W' com~ny Is• CETC which onty r t c• lvt.a froitn suppon_. yoYr pro1reu rt port Is only

<113>

<114>

<115>

<116>

<117>

<111>

required 10 1ddrtu voice telephony service.

Please Mie(l the appropriote ruponstS below (Y• " No, Not Applicable) to oonfirm

thlt the 1n.cMd document(s), on line 112, eontaJns 1 procren report on h.J five.ye_.,

semce quofrtv lmP<owmtnl pion punu1nt 10 JSC 202(1) The lntormotlon shift bo

submitted at the wtre eent•t lewl or cen.tuJ bloctc IJ approprl.a~

Maps det111fna Pf'oCt•u towuds meet1n:1 pl.an t1r1eu

Report how much unlvt r-ul 11rvke (USF., support wu recttved

How mucll (USF) was uMd lo 1_. oeMce qualty wld how-1 was used lo 1,,.._ ooNloe qual1y

How mucll (USF) wu uttd lo ln'4>tove .....ioe OOY«9QO wld how ..,ppor1 .... ueed lo i"'4"0Yt w.1ot ...,...

How mucll (VSF) wa ulOd lo omproye uMce ...,...iy wld how 1Upp01t wu 11Md lo~ w.4ce ...,.aty Prov'de 1n e.-pCan.aUon o( network lmprO't't ment tu1eu not met In the P<ior calendar year.

FCC form C81

OM8 Control No, 3060'°986/0MB Control No. 3060.()819 July 2013

Name of Att1ched Oocumtnl

, .,. 2

Poat 2

Page 3: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

1200) S.rvk• Oul•I• Reportlnc (Vokt ) D•ta COltctlon fOtm

~010> Stud ,,.,.. Code

<OlO> p, am Ye.tr

<a> <bl> HOltS

<b~

""""'" °"'"'•St0f1 OVUceStttt NvL"l'ltt*' Date -·

<\)>

OVtaceCftd

O•t•

tH021

JOU

M.rlt1-rt

1'tlf"'lato~•ll~ . cc.

<l>l> «I> «1>

Ovtce Cftd HaMllerof Tim• °'"°""..,. ~ecttd ToUIHVMINt ol

CUltomWI

<4>

tllf-Atfe<ted

IY•/Nol

KCf0<mq1 OMBConttcl No. ~/OM8Comt<>INo. -19 July 2013

<•> <f> «> <h>

°"'""'O..UC• -°"'- A/feaM ......

_......,(Chedo Study Alee• ~Ou- Pfllftftt.UW ...... _.., IY•/ Hol ·- Proced\tret

Page 4: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

(100) Prtca Olfttlnp ....,.,.... Volcil - 01111 Oot8 Coltclion ,_

<015> Study NH Name

tUOU

<010> Pt r.am Vut J:OU

<101> ~UIU .. LD<.tl ~tCh.t'I~ (ff«tfvet>.&ce

c702> Sine!• S111 ... widt Rrtkl•nli•~ loul SefVl<.c Chara•

<?Ol,.

Stat.t flrchMat!lllcl SAC(CCTCI

, .,.,, ... <bl>

...... d•lloml hteTYM s..rvke•••• St.le 5-.ah Unt Ouw·te

FCCF«m'81 O..Gontrol No. ~Control No. ~' July 201'

MWKooyOrt...i..tlvH State Uf'lfvenel s.en4ce Ftt -""-· TOCll Hf••••t•lef'ld r ..

,.,.4

Page 5: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

(110)1 ........ nd~Olhrinp 00111 Col«tlon ,_

<010> ~hid Alu COdt

<71b

Stal•

.. ,. l'.achMHllU:CI

lltoU

UlUO&Ol1 U-t

r.,.uletory•e:ell ........ . C091

Sllt.elttf\'"1td ltetldtnti.t Rite rn1 Toe .. "-t• tttd Feff

<ell>

ltoMMnd $.mike •

Oow!..io.dS9<e<I , ........

rccr....,.,1 OMI Conllol No. JOI0.°"6/0M&Coolrol No. JOMl.Ollt .hllyZOlJ

u....-. ltoedblnd Stnk:c • UwtitMowtftce 4ttloftfaUn°tN't'lfft

ll~d SNed fMllot1 IGll Umft ltac:hed , _ _,,_'

Pa1•S

, •• s

Page 6: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

(IOO) o~r1t1nc Comp1nlft

DIUI CoUtctlon Form

<010> Stud Afta Code

<015,. Study Alea N1Me

<OlO> Cont.Kt Hamt ·Person Us.\C t.houkt contact ttprdrn1 thfs dna <OlS> Contact T'*Phone Humbef Humber of per'°" kfentlfled In data line <030>

<110> Report!nlCMTI«

<&lb tWd:rs Comea:ny

<812> Op<utiog Compony

<Ill> <al>

Alfiflltts

ttt02J

&ol u y lreJsu Ll£

JO\f

t0'110l0\ I n.l

--Qb

SAC

rccr...., 411

OMI Contr .. No. ,__/OMB ConllOI No. 3060-0819

Julv20U

qJ>

Doi .. ,_,,.. '-*'Y or atMd OeslJnallon

Pqe6

I

Page 7: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

(900) Trlbll Lands Reportlnc 01t11 Collection Form

<010> Stud Area COde <015> Study Arca N1me <020> Pro r1mYear <030> COntact Name · Person USAC should contact reprdln& this data

tU02J

M•ht tUulen LLC

20U

<035> COnllct Telephone Number · Number of person ldendfled In dato line <030> <039> Contact Emili Address· Emili Address ol person Identified In data line <030>

<910> Trobal land(s) on which ETC Serves

<920> Trlb1I Government En1a1ement Obllaauon

II your company••"'•• Trlbol lond1. oleue Mle<t IYts.No. NA) lor uch these boxes to confirm the status dtsaibtd on lllt ll!achtd documtnt(s), on l!nt 920,

d1monnr1tes coordin.tdon with the Tribll 1overnrnent punuant to

f S4.l lll• K91 lncludts:

<921> Needs assessmonl ond doploymonl planning with o focus on Tribal communky anchor fn1tftu!lona.

<922> Fe11lblllty ind sunalnablllty planning;

<923> M1rkeUn1 services In 1 culluralfy sensitive manner;

<924> compliance with Rlahls ol wav processes

<925> Compliance wllh land Use permitting requirements

<926> COmpli1nce wllh Facllltles Sltlna rules

<927> Compliance with Environmental Review processes

<928> Compliance with Cultural Preservation review proceues

<929> Compliance With Tribal Business and Ucenslna requirements.

Saitcl Yes or Noor

Not.Aeobbl•

P11e 7

FCCForm411 OMB Control No. J060.0986/0MB Control No. 306().()819

July20ll

N1mt of Attachtd Oocumtnl

Pase 7

Page 8: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

(1100) No Terrestrial Blckhaul Report!,. D1t. Collectlon Form

<010> Stud Area Code <015> Study Area Name <020> Proer~m Year

<030> Contl<t N1mc • Per..,., USAC should conuc:t re1ordln1 this d•ta <035> Cont•ct Telephone Number· Number of person ldcntillcd In d1ta line <030>

<039> Cont•ct Em11I Addrc" ·Email Addre" of person Identified In dna llne <030>

<1120> Pleaile confirm WhothOf torrosltial bad<ttaul op1lon1 exls1 within the supported aroa pursuant to§ 54.313(9) (Yos, No) •

11tOU

JOU

r!f\!lac.orrs-ll-IJ'l"004 c.

• 1130

, Please select tho appropnale responeo (Yes. No, Not Applicable) io ccnlinn the

rcjlOr1lng c.>trior olfon bfoadband seMC8 of et least I Mbps downstream and 256 l<bps

upstream within the suppotted area pursuant to§ 54 313(g).

FCCForm481 OMI Control No. 3060-0916/0MB Control No. 3060-0819 July2013

P•ae8

Page 9: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

(1200) Terms and Condition for lifeline Customers llfellne Oat. Collectlon Form

<010> Stud Aru Code

<015> Study Area Nome <020> Pro ram Ye1r

LUOU

<030> Contact Name • Perion USAC should contact regarding this data ,..ti! !.t .... u <035> Contett Telephone Number . Number or person Identified Jn data llne <030> 4.0,2'0\Gt I .~,

<OS9> Contact Emall Address .. Em1ll Address of person ldentl~ In data line <030> uqul.titoryeulton]W:OCl .fOlll

<1210> Terms & Conditions of Ve><ce Telephony Ufe llne Pl1ns

<1220> link to Pubne Website

·P11-..s.e cMd th1M bales betow to cOftfirm thal I.he attxhed docc..wnitnt(s), on line UlO,

Ot !ht "'tb1itt ~sttd, on lint tUO, contolns tht requhd lnlonn1tlon puNUOnt lO

t s.t 4ZZ(•KZJ 1nnu1l 11-1ln1 f0t CTC. rtctN•n1 low~nc0tnt su-. c•rO.rs must annul-fly report

< 1221> 1nform1tlon descrlbln& the terms and conditions of any voice telephony service plons offered 10 Llfellne subscribers,

<1222> Details on the number of minutes provided 11 part ol the plan,

<1223> Additional charaes fortoll calls, and ratu loreach such plan.

FCC Form4'1 OMB Control No. 3060-0986/0MB Control No. ~19 July20U

Hime of AttKhed Document

Page 9

Page 10: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

(ZOOO)MCllClpClrrlet~--

0.C.. Collo<tlonf-

'"dudl

<010> Stud AIHCod• <OlS> S.l.ldyN•• Name <020> Propam't•• r <OJO> Coritan Name . 'enon UW tt.owkl <ontKt u1!!11inf thl\ data <03S> C-U d T!l!p!lone- • H-., ole«?Oft.i...tort.d In d•t• llnc <OJO> <039> Cont.ct (mal Address· EmAtl Addteu or eenon ldtnbn.d In datt h cOlO>

Ahil( lifilhi W!

JOii Mitk CWit COJJIOlGil WA

f qGli(blf'Wh ilW;:µa&i &a

Ptte 10

KCforto"1 OMICGnWI No. JCMO.OM6.IOMICOft1191No J060-Gllt MtZOlJ

Se-lea the •PP'oPJ·llt• ruponMS kJow (Yu. No, Nol A.Hlk.tl>Le) to nM• complt.nu H • rtclpkint of IAC1emtftraf Coftftt<t AM•rk• Pl'la.141 I tuppott. trouft H'sh Cott M.lPPGrt. Hiah C.otl ttifPP<M't to offset a<Cfft dlar1• '""~"and Conned Amtrk• PhtM II S41PPOl1. aJ i.et fordii In 4'1 GR t S4 •. J1S(bi(c),(d}.(t). The lnfor,...atJoft reported on lhb form 1ncf m die docum1:nu attKht'd b-l:tow b IKC:w,atc,

llM:femetttal Coftne<t Ametb 'h• .. I te:pot'Unc

<2010> ,.,.. v ... c .... fb..,..147 crR t S4 llJll>K•M <20u.> lrdYHr Cm.llco-{'7CU§S4 llJ(bKl)o)

<20Ub> AnKhment(47CfRt S4 Jll(bKl)ll)

Price C.p C.fflt< R.W.ln1 fro<en Suppon Cettlfl .. 11.,. (47 UR t 54.JU(IJl <2012> 201) frottll Suppon c.kvl•<'°" (41 CfR t SUU(cl(I Jl <20U> 7014 Fro1.., Su"'°" c.ta.U_, (0 CfR t S4.llll<K1Jl <2014> 101~ fto:M ~ c.i<ul•-10 CfR t SOU(<l{lJl <20JS> !01'""' """" r,.,.., "'Ppott C•l<ul• oon (O CfAt S• llJtcK• Jl

<2016>

<2017> <2011• <201,,

<2010>

<20.ll>

PtkeC.,.Canff, C-oo<t ......... ICCS"-(47CHf '4.lll(4Jl C...UR<•,JOA SuPPort Uc.cl 10 lulkl &ro•db• ,,d

Connt<t Am•rica Phase JI hpottln1 (47 Ult I S .. JU(•)) Jrd ¥Ht lkotdb1nd S..rvke Ctttlflcatk>n Sth VHt lroadbtnd Scf\okt (Mtlfiutl°" tmfflm Pfop-eu Ct«Jfklillon

Pit•,. chK~ th• bor to conftrm !hot the •ttl<hed documenl(1), on Un. 2021.cont>ons lhe required lnlorrNtfo<> putSu>nt lO t 54.JU (t )(J)(•I. 11 • r.Qplent of CAI' Phi>4 ll support Jholl prOVICM the number, names, end ~------~ ~dteue.s ot c~kv anchor lnst,MJons to which bec•n prOVKlu,1 a«<u to brotdb•nd service fft the prea:d1n1 calotndar year

,...,.o

Page 11: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

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Page 12: ANNUAL REPORTING FOR AU CARRIERS :'.:,' T' I · (100) Service ~hty 1miwoveme1lt R~portlnc Data Collealon Fo

1·--°'----·­.... ~-

13027) Revtnue

130281 Opemfnc E•c>ensos

13029) Net Income

(3030) Tt lephont P11nt In S.rvlce{TPISJ

13031) TotolAuets

(3032) Tot.I Debt

(3033) Tot•I Equity

(3034) Dividends

&ulf& Mlrstc11 P.l'

fQUtqup nt 1nulet pgytc•tlgnaytj er•

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Paa• 13

FCCForm481 Certlfbtlon - Reportlna Clrrler 0•1- Collectlon Form OMB Control No. l060-49B6/0MB Comrol No. 306().()819

July 2013

<010> Study Arn Code 18902)

<015> Study Area Nome

<020> Pro rom Yur 2016

<030> Contl<t Nome · Person USAC should contact ro1ardlnt this data Kuk Lawrt

<035> Contact Telephone Number - Number of person Identified In data line <030> <072601011 ext .

<039> Contl<t Emoll Address - Email Address of person Identified In datJ llne <030> requlatorxecol long"'°"" com

TO BE COMPLETED BY THE REPORTING CARRIER, IF THE REPORTING CARRIER IS FILING ANNUAL REPORTING ON ITS OWN BEHALF:

Certification of Officer as to the Accuracy of the Data Reported for the Annual Reporting for CAF or LI Recipients

I certify that I am an officer of the reporting urr!et; my respon•lbllltles lndude eMurtna the accuracy of the annual repott1n1 requirements for universal service support redplenu; and, to the best of my knowledae. the Information reported on thlJ form and In any attachments Is accurate.

Name of Reportlns Clrrler: A11Jet Wtr:e l cea LLC

Slsnature of Authorized Otfictr: CBRTrPIED ONLitlS Oate 06/19/2015

Printed name of Authorized Officer: Byron Young

Title or position of Authot1zed Officer: Cito

Teleohone number of Authorued Officer; 117450121 ext.

Study Area Code of Reportln1 Clrr!er: 10023 filln• Oue Date for this form 07/01/2015

Ptnons-lflilly ml~"'C l•IM stn..,,.nu on this l<><m can bt punl>i..d.,., llne0t lorlo•w,. under U..Communlcotlon> Act ol 193• , '7 USC. U SOZ, S03(bl,or ftnt or lmpnJonnMtnt undtr Titi. 18 of the Unit• d SUIA!I Cod•, 18 U.S C. t 1001

Pace 13

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CartlflQtlon • Aaent I Carrier

01t11 Collectlon Form

<010> Study Ate• Code

<015> 5tud)IAru Name

<020> Pf m Ye1r

I H02)

M atat tifll'"e l eaa LLC

201'

<OJO> Con tut Name · Perion USAC shO<lld C<l<lllct rttardln1 this d111 Mark Lawrt

<035> Cont>ct Telephone Number · Number o( person Identified In d•ll line <030> 407260 10 11 u t

FCC F°"" '81 OMB Control No. 9060-o986/0MB Control No. ~19 July201'

<039> Cont1ct Emall Address · Em•il Addreu of person IOentrfied In datl One <030> regu l a t.oryeca l l on gvood c Olft

TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING ANNUAL REPORTS ON THE CARRIER'S BEHALF:

Certification of Officer to Authorize an Agent to Fiie Annual Reports for CAF or U Recipients on Behalf of Reportinc Carrier

I ctrtlty lh1t (Name or Agent) 111ulho<lud to 1ubmlt lhe lnfonmaUon reported on beh11f or lh• reporting canl..-. I llao cetllty lhlt I am on omcor of lh• reporting corTler: my re1pon1lbmt1 .. 1nctude on1uTlng lh• occvrecy of the 1nnull d1t1 ,.porting requlremonta P<OvlCS.d to lhe 1Ulhorl1td agent; ond. to ltle bttt or my knowtedge. It!• reports and data provided to lt1e aulho<l1td agent 11 accurate.

'lame o( Authorlled Allene

N1me of Rer'll0ft1ntr: carnet

S11noture of Authomed Officer: Dito:

Printed name of Au1horiled Officer.

Tltle or po1ltlon or Authorlled Offieer;

TeltDl1one number of Authorized Officer:

Studv Areo Code of Reporting C.rrler: FlllnJ Due Date for this form:

p,r10f\J wtHfulty makll'I false 1tattmtt1U on 1hlt fotm ~n be punbhed by Rne or forfeUure undet th• Communk.aUons Act of 1914, 47 U.S.C. H ~:Z, ~0.)(b}, or fine or Jmprl\onment under Tille 18 of tilt Unh.ed Stott< Codt , II U S.C. § 1001,

TO BE COMPLETEO BY THE AUTHORIZED AGENT:

Certification of Acent Authorized to File Annual Reports for CAF or U Redpient.s on Behalf of Reportln1 Carrier

I, u a1ent for the reporting carrier. certify that I am authorlad to submit the 1nnual reporu for unlvtrsal service support re<lpltnts °" bthalf of tht rtportlng carrier; I hive p1ovlded the d1t1 reported herein bued on dai. provided by tho reporting corrlet; and. to the but of my knowledge, the Information reported herein Is 1ccur1te .

N1me of Reoortlfll Carrler:

N1me of Authorized A&Mt or fmDlovee of Al!ent:

Si1n1turt o( Authorized Aatnt or fmpl"""e of A1tn1: Diie :

Printed name of AUthorlled Al!tnt or Emn"""'t of A.1tnt:

fltlt ot oos11loft of Authorized Agont or EmDlovoe o( Aatnl

tTeleahone number of Authorized Aa<nl 0< Em""'-e of Al!ent

S"""' Area Code o( Repotlln11 Cottier: Flina Du• Date for thl• form·

P«fWW1twlff\llym~1 t.tke S'.lltm1enu on thfs tOfm an be p.1niJ.hed by fine or (orlature ul\dcf lheComn\unk.Mions Actof 19lA. 47 U.S C. H SO>, SOJ(b,_ Ot fl!M Ot ~prisonm~l undtt Tid• 18 of the Unhed St.ttt1 Codo, II U.S.C. t 1001.

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Attachments

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FCC Form 481 Section 500 - Service Quality Standards & Consumer Protection Rules Compliance

Under FCC Rules, Section 54.202, an ETC must comply that it will satisfy applicable consumer protection and service quality standards. Assist Wireless, LLC (Assist Wireless) is in compliance with the Cellular Telecommunications and Internet Association's Consumer Code for Wireless Service.

I. Assist Wireless discloses rates and terms of service to customers at the time service is initiated. These same terms and conditions are posted on Assist Wireless's website at www.assistwireless.com.

2. Assist Wireless provides service availability information on their website at www.assistwireless.com.

3. Assist Wireless provides contract terms to subscribers when they injtiate or change service. These same terms are provided to subscribers during the annual recertification process as outlined in Commission rules that govern continued subscriber eligibility.

4. Assist Wireless's Lifeline service can be terminated at any time by either party without an early termination fee. Service is dependent on continued usage and eligibility in the program.

5. Assist Wireless provides disclosures, minutes included in Lifeline plans, expiration of rollover minutes, availability of service, and cost for additional minutes in published Lifeline advertising materials.

6. Assist Wireless customers are provided options if they exceed the number of minutes provided in their Lifeline plan. If at any time a customer purchases additional minutes, charges and plan options are available on the company website at www.assistwireless.com.

7. Assist Wireless's toll-free customer service number is 855-392-7747. Customers may also dial 611 from their Life Wireless handset to reach customer service free of charge or by contacting Assist Wireless via email at [email protected]. This infonnation is provided in the terms of service and on the company website and in all infom1ation provided to subscribers.

8. Assist Wireless responds to all consumer inquiries and complaints received from government agencies witrun 30 days.

9. Assist Wireless has procedures in place to maintain the privacy of subscriber proprietary information in accordance with applicable federal and state laws.

l 0. Assist Wireless has available to Lifel ine customers an on line porta l where customers can check their balances and purchase additional minutes.

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FCC Form 481 Section 600 - Functionality in Emergency Situations

Under FCC Rules, an ETC must demonstrate its ability to remain functional in emergency situations. Since Assist Wireless, LLC (Assist Wireless) is providing service to its customers through the use of facil ities obtained from other carriers, it is able to provide to its customers the same abi li ty to remain functional in emergency situations as currently provided by the carriers to their own customers, including access to a reasonable amount of back-up power to ensure functionality without an external power source, re-routing traffic around damaged faci lities, and the capability of managing traffic spikes resulting from emergency situations.

Assist Wireless, along with their underlying carriers, have created back-up systems to ensure functionality in the event of a loss of power or network functionality. Assist Wireless's support facilities are housed in a carrier-class data center with fully redundant power and HVAC, a controlled temperature and humidity environment, fire-threat detection and suppression, year­round critical monitoring, and secure access with biometric security. The facility features redundant generators and redundant fiber optic connectivity. The data center is a reinforced concrete building located in a secure area and collocated with the area electrical generation plant. All systems within the faci lity are implemented on redundant servers, each with redundant data network and power.


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