Tim OHara AT&T nc. Manager 1122lh Street, NW External Affairs Suite 1 Washington. D.C. 236 T: 22.457.2267 F: 74.548.383 tohara@att.com February 1,216 Ms. ngrid Ferrell Executive Secretary Public Service Commission Post Office Box 812 Charleston, West Virginia 25323 Re: AT&T Mobilitv Annual FCC Wireless Lifeline Recertification Filing Dear Ms. Ferrell: n accordance with the Order of the Federal Communication Commission ( FCC ) released February 6, 212, in WC Docket No. 11-42, eligible telecommunications carriers are required to annually report on FCC Form 555 the results of their Lifeline recertification efforts to the FCC, the Universal Service Administrative Company ( USA@ ), and to the respective state commissions. Enclosed please find AT&T Mobility s completed FCC Form 555 for calendar year 215 for West Virginia. know. f the Commission or Staff has any questions regarding this report, please let me Respectfully, Enclosure
November 214 36-819 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 PQRTANT: PLEASE REA NSTRUCTONS FRST Deadline: January 31'' (Annually) 291 2 Study Area Code (SAC) (An Eligible Telecommunications Carrier (ETC) mustprovide a cerr$cntion/orm/or each SAC through which itprovides Lifeline service). wv State AT&T Mobility ETC Name AT&T Mobility LLC DBA, Marketing or Other Branding Name (lfsame as ETC name, lis1 "N/A " Do nor leave blank) Holding Company Name (lfmme us ETC name, lis1 "N/A " Do not leave blank) Does the reporting company have affiliated ETCs? Yes No fa Provide a list of all ETCs that are affiliated with the reporting ETC, usingpage 4 andadditional sheets ifnecessary. A/filiafion shall be derermined in accordance with Section 3(2) ofthe Communications Act. That Section defines "a/filiate " as "a person that (directly or indirectly) own^ 1 controls, is ownedor conlrolled by, 1 is under common ownership or control with, anotherpevson." 47 U.S.C. $153(2), See also 47 C.F.R. $ 76.12. Affiliated ETC's SAC -_ See attached worksheet -- /Affiliated ETC's Name 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 bylaws (or partnership agreement), and would typically be president, vice president for operations, vice president for finance, comptroller, treasurer, or a comparable position. f the filer is a sole proprietorship, the owner must sign the certification. Section L; nitial Certification,411 ETCS must complete thrs section certify that the company listed above has certification procedures in place to: A) Review income and program-based eligibility documentation prior to enrolling a consumer in the Lifeline program, and that, to the best of my howledge, the company was presented with documentation of each consumer's household income and/or program-based eligibility prior to his or her enrollment in Lifeline; and/or B) Confirm consumer eligibility by relying upon access to a state database and/or notice of eligibility from the state Lifeline administrator prior to enrolling a consumer in the Lifeline program. am an officer of the company named above. 1 am authorized to make this certification for the Study Area Code listed above. nitial sam 1
~~ ~~~ ~ FCC Form 555 November 214 ADDroved by OMB 36-819 Annual Recertification Do not leave empty blocks. lfan ETC has nothing to report in a block, enter a zero. A subscriberr claimed on February FCC Form 497 of (Februnry dnro moath) B lines claimed on February FCC Form497 of provided to wireline resellers subscribers claimed on the February FCC Form 497 that were initiallv enrolled in the current Form 555 (These subscribers did not have Lifeline serviceprior to January of the currenf 555 cnlendar year.) C D subscriben de-enrolled & to recertification attempt by either the ETC, a state administrator, access to an eligibility database, or by USAC E = (A-B- C- D1 subscribers ETC is responsible for recertifying for 68 1 13 54 Recertification Results: F G H = (F-G) J = (H+) subscribers ETC contacted directly to recertify eligibility through attestation subscribers reponding to ETC responding subscribers responding that they are no longer eligible (This should be a subsef of Block ~ ~ ~ enrolled or scheduled to be de-enrolled as a result of nou-response or response of ineligibility frorn ETC 1 G.) recertification attemot Note: f any subscriber was reviewed by an ETC accessing a state database 1 by a state administrator and subsequently contacted directly by the ETC in an attempt to recerfifi eligibility, rhose xubscribers should be listed in Blocks F subscribers whose subscribers de-enrolled or through Jas appropriate and no1 in Blocks K and L. As a result, all subscribers eligibility was subject to recertificcnrion who were not de-enrolled prior 1 the recertsfication reviewed by state a result of finding of attempt muxf be accounted for in Block F or Block K. administrator, ineligibility by state ETC access to eligibility administrator, ETC access to database, or by USAC eligibility database, or USAC total ofbbek F and Block X should equal the number reported in Block L. 11 56 Certification: Based on (he data enreredabove. initial the certificat;on(x) below that apply. Both Certification A and B may apply depending on the recevttjjcation proceduves in placefor the SAC reporring on thisform. f Certification C applies, neither Certification A nor B may apply, A.) certify that the company listed above has procedures in place to recertify the continued eligibility of all of its Lifeline subscribers, and that, to the best of my knowledge, the company obtained signed certifications from all subscribers attesting to their continuing eligibility for Lifeline. Results are provided in the chart above in Blocks F through J. am an officer of the company named above. am authorized to make this certification for the SAC listed above. nitial AND/OR B.) certify that the company listed above has procedures in place to recertify consuiner eligibility by relying on: USAC. Results are provided in the chart above in Blocks K through L. am an officer of the company named above. 1 am authorized to make this certification for the SAC listed above. nitial Sam OR C.) certify that my company did not claim federal low income support for any Lifeline subscribers for the February Form 497 data month for the. am an officer of the company named above. am authorized to make this certification for the SAC listed above. nitial 2
November 214 36-819 De-enroll Percentage Using the dafa entered in Section 2, complete fhe charf below fojind fhepercentage of subscribers de-enrolledfor rhis ETC. M 3 (F+K) subscribers that the ETC attempted to recertify directly - or through a state administrator, ETC access to a state database, or by USAC (This should egualfhenumber reporied in Block E) 56 N = (J+L) subscribers deenrolled or scheduled to be de- enrolled as a result of non-response or ineligibility 11 = ((N im) * 1) Percentage of subscribers de-enrolled or scheduled to be de-enrolled as a result of ineligibility or non-response 19.64% P Month Q Subscribers De-Enrolled for Non-Usage February March May June July August September October No v e m b e r December Total Subscribers By signing below, certify that the company listed above is in compliance with all federal Lifeline certification procedures. am an officer of the company named above. am authorized to make this certification for the Study Area Code (SAC) listed above. Scott A. Mair - SVP Technology Signed, Planning 8, Engineering Certified Online Signamre of Officer sm2389@,att.com Printed Name and Title of Officer 1/15/216 Email Address of Officer Date Jose Silva 787-554-857 Person Completing This Certification Form Contact Phone Number
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