Oklahomauniversal Service Fundrequest for Funding

OKLAHOMAUNIVERSAL SERVICE FUNDREQUEST FOR FUNDING

INSTRUCTION PACKAGE

Updated: September 8, 2017

OklahomaCorporation CommissionPublicUtilityDivision

JimThorpeBuilding, Suite 580

OklahomaCity, OK73105(405)521-4114

TABLEOFCONTENTS (continued)

PAGE

SECTIONFIVE

PrimaryUniversal Service Request Form(Form PUSF–1)...... 22

Special UniversalService Request Form (Form SUSF-2) / Internet Access

Schools and Libraries..…………………………….……………………….…...25

Special UniversalService Request Form (Form SUSF-3) / Telemedicine for Healthcare Providers………………………………………………………….…27

Oklahoma Universal Service Fund LifelineReimbursement Request Form

(Form OLF–1)...... 29

SECTIONONE

FILINGGUIDANCE

LOCATING FORMSFOR REQUESTINGFUNDING FROM THEOKLAHOMAUNIVERSALSERVICEFUND (“OUSF”) AND THE OKLAHOMA LIFELINE FUND (“OLF”)

Theappropriateforms necessaryfor making an OUSF or OLFfunding requestshall beavailableon the Commission’s website at the following location maybeobtainedfromthe OUSFAdministrator (the “Administrator” or Public Utility Division “PUD”).

(Reference:OAC165:59-3-61)

LOCATING OUSFINFORMATIONON THEWEB

(1)Goto theOCC server homepage(

(2)Select“Divisions”

(3)Select“PublicUtility”

(4)Click on“Telephone”

(5)Click on“Oklahoma UniversalServiceFund”

(6)Thenchoosefromthemenuthe particular informationyou seek

PROCEDURESFOR REQUESTING PREAPPROVAL FOR OUSF FUNDING

(Reference:OAC 165:59-3-66)

Preapproval is an optional process available to OUSF Beneficiaries who desire to have certainty regarding the amount that will be funded from the OUSF in support of Special Universal Services on behalf of the OUSF Beneficiary.

(1) The OUSF Beneficiary may submit a "Request for OUSF Preapproval" to the OUSF Administrator to determine eligible services and credit amounts for the upcoming funding year.

(2) A Request for OUSF Preapproval may be submitted at any time by sending via electronic mail a digital copy of all required documentation to the OUSF Administrator, to the email address

(3) The Request for OUSF Preapproval shall include the following:

(a)All documents and information required by the approved form; and

(b)All documents identified in 17 O.S. § 139.109.1(F)(2)(d).

(4) The Request for OUSF Preapproval may include any documentation that would assist the OUSF Administrator in independently evaluating the request.

(5) The OUSF Administrator shall independently evaluate and review the Request for OUSF Preapproval, including all provided documentation, and issue an OUSF preapproval funding letter, without Commission order, to the OUSF Beneficiary within ninety (90) calendar days of receipt of the Request for OUSF Preapproval. The preapproval funding letter shall be electronically delivered to the OUSF Beneficiary.

(6) A Request for OUSF Preapproval that is found by the OUSF Administrator to be incomplete, i.e., missing affidavits, bid informationor other pertinent information may be denied.

(7) After a preapproval funding letter has been issued, an OUSF Beneficiary may submit a new Request for OUSF Preapproval to provide corrections or provide additional information; however, a new Request shall be submitted for each funding year. This new Request shall be submitted by sending via electronic mail a digital copy of all required documentation to the OUSF Administrator, to the email address .

(8) Unless an OUSF Beneficiary receives preapproval of a Request for OUSF Preapproval, the Beneficiary shall not identify the OUSF as the source of secured funds for any purpose.

(9) The amount of OUSF funding preapproved under this subsection shall be subject to adjustments based on the amount of support received from other sources, if any, as well as adjustments to pricing that may occur between the time of preapproval and installation of service.

(10) Additional services that are installed beyond those contained in the Request for OUSF Preapproval shall require either a new Request for OUSF Preapproval or a Request for OUSF Funding to be filed.

(11) Variance from the terms approved in the OUSF preapproval funding letter, which could have impacted bid selection may make the previously issued OUSF preapproval funding letter null and void.

(12) A Request for OUSF Preapproval submitted by an OUSF Beneficiary shall be signed by an authorized agent of the OUSF Beneficiary, or by the attorney for the OUSF Beneficiary.

PROCEDURESFOR REQUESTINGFUNDINGFROM THEOUSF

(Reference:OAC 165:59-3-68 or 165:59-3-70)

Note: All eligibletelecommunicationserviceproviders areencouraged toobtainandreviewacompleteset oftheOCC Rules(Chapter 59) related toOUSF.

(1)An eligible telecommunications carrier oreligible provider of Special Universal Services requesting fundsfromtheOUSF shall file a “Request forOUSF Funding” withthe Commission Court Clerk’s Office. Documentation not filed with the Court Clerk’s Office, in support of the “Request for OUSF Funding”, should be givendirectly to the OUSF Administrator or e-mailed to

(2)Requests for OUSF Funding found to be missing required information, i.e., affidavits, bid information, invoices, contracts or tariffs appropriate SUSF forms, etc., may result in a denial of the requested funding.

(3)It isthe intention ofthe Commission thateachfunding request will be reviewed on a case-by-case basis. For requests regarding Primary Universal Services, the eligible local exchange telecommunications service provider shall make every reasonable and timely effort to obtain funding from alternative funding sources designated to support Universal Serviceor an explanation for why alternative funding is not available. For requests regarding Special Universal Services the OUSF Beneficiary shall make every reasonable and timely effort to obtain funding from state and/or federal funds, such as the federal Schooland Libraries Program or the Rural Health Care Programs designed to support Special Universal Services.

(4)If an eligible local exchange telecommunications service provider or eligible service provider receives fundingfrom alternative funding sources foran investment, expense or service reimbursed by the OUSF, thecompanyshall reduce theamountofany prospective funding request fromtheOUSFbyan equivalent amount. Under no circumstanceswill double recovery be allowed.

(5)Concurrent with the filing ofthe Request for OUSF Funding, the eligible telecommunications carrier or eligible service provider requesting fundingfromthe OUSF shall provide copies of the Noticeofthe Request for OUSF Funding to the OUSF Administrator, to theOklahoma Attorney General to the OUSF Beneficiary andtoeachtelecommunications carrier intheStateofOklahoma, which is a contributor to the OUSF. In addition, the eligible telecommunications carrier or eligible service provider requesting funding shall provide copiesofthe Request for OUSF Funding to the Attorney General,to the OUSF Beneficiaryand,upon request, to other telecommunications carriers. The Administrator shall provide a listofthe contributors to the OUSF upon request byan eligible telecommunications carrier or eligible service provider.

(6)The Request for OUSF Funding shall be reviewed and processed consistent with OAC 165:59-3-68 for Special Universal Service requests or 165:59-3-70 for Primary Universal Service requests.

(7)Any adversely affected party shall have fifteen (15) days to file a request for reconsideration bythe Commission of the Determination madebythe Administrator. The party requesting reconsideration shall give noticeof the request for reconsideration to the provider making the Request for OUSF Funding, the Attorney General, the OUSF Administrator, and all parties to the Cause. Upon filing the Request for Reconsideration and the Notice of Prehearing Conference, the Request for Reconsideration shall, without Commission order, be assigned to an ALJ, and set for hearing on the next regularly scheduled prehearing conference date, which is at least five (5) business days after the date of filing, unless the parties agree or the Commission directs otherwise.

(8)Unless good cause is shown, any request for OUSF funding should be made within eighteen (18) months from the date the requesting eligible service provider can determine the impact of occurrence of the circumstance giving rise to the request; however, if an OUSF Beneficiary has obtained a preapproval funding letter from the OUSF Administrator, the eligible provider shall make a request for funding within 60 days of the start of service.(Reference:OAC165:59-3-68-m).

DEFICIENCIES IN THEREQUEST FOR OUSF FUNDING

AnyRequestforOUSF Funding may be denied iftheRequest is found to be incomplete.(Reference:OAC165:59-3-68-e and 165:59-3-70-e).

REQUESTS FROM THE OUSF ADMINISTRATOR FOR ADDITIONAL INFORMATION

The OUSF Administrator may request additional information from the eligible service provider, eligible telecommunications carrier, or the beneficiary as is necessary to fully evaluate the Request for OUSF Funding. This information must be provided in a timely manner (generally ten (10)business days) fromthedate that such information is requested by the OUSF Administrator.

IF YOUHAVE QUESTIONS

WhenyouhavequestionsregardinghowtorequestfundingfromtheOUSF,pleasecontact:

OklahomaUniversal ServiceFundAdministratorOklahomaCorporationCommission

PublicUtilityDivisionP.O.Box52000

OklahomaCity,OK 73152-2000(405) 521-4114

DOCUMENTS REQUIRED TO FILE A REQUEST FOR OUSF FUNDING

(File the following items are to be filed with the OCCCourt Clerk)

(1)RequestforOUSFFundingwithcorrespondingCertificateofMailing

(2)NoticeofRequestforOUSFFunding

(3)SUSFForm(theExcelversionoftheSUSFFormmustbesenttoPUDviaemailonthesamedaytheRequestisfiled,andtheemailmustincludetheExcelversionoftheSUSFSpreadsheet)

(4)*AffidavitandAttachmentstotheAffidavit–seebelowforexamples

REMINDER: Pursuant to OAC165:59-7-17, prior to signing a contractwith a school, library orrecipientof a telemedicine line,theprovider shallprovide tothe OUSFBeneficiary writteninformationregarding thelimitations on funding from the OUSF.

*AffidavitandAttachmentstotheAffidavit-examples:

A.WhentherehasnotbeenaPreapproval,provide:

AffidavitandallrequiredAttachments

B.WhenanApprovalFundingLetter(“AFL”)hasbeenissued:

WhenaAFLwasissuedpriortotheBeneficiary’sselectionofabid,andthentheBeneficiaryselectedtheLowestCostReasonableQualifyingBid(“LCRQB”)andnootherchangeshaveoccurred–provide:

UpdatedAffidavit if there has been any changes

AnyAttachmentstotheAffidavitnotpreviouslyprovidedorthathavechanged,e.g.,FCCForm471,contract,invoices

WhenaAFLwasissuedafterthebandwidth/bid/carrierwasselectedbytheBeneficiary,theBeneficiaryselectedtheLCRQB,andnochangeshaveoccurred(includingchangestotheAffidavit)–provide:

AnyAttachmentstotheAffidavitnotpreviouslyprovided,e.g.,disconnectinformation,invoices

WhenaAFLwasissuedafterthebandwidth/bid/carrierwasselectedbytheBeneficiarybutpriortowhentheBeneficiaryfileditsFCCForm471,andthentheBeneficiaryselectedadifferentbandwidth/carrier/bid–IftheBeneficiaryseeksandreceivesPreapprovalandthensubmitsaRequestforFundingthatdoesnotreflect/matchtheAFL, theRequestisconsideredtobea“new/different”RequestwhichhasnotbeenPreapproved.Provide:

UpdatedAffidavit if there has been any changes

AnyAttachmentstotheAffidavitnotpreviouslyprovidedorthathavechanged,e.g.,FCCForm471,contract,invoices

WhenaAFLwasissuedafterthebandwidth/bid/carrierwasselectedbytheBeneficiarybutpriortowhentheBeneficiaryfileditsFCCForm471,andthentheBeneficiaryselectedadifferentbandwidth/carrier/bidinordertoselecttheLCRQB–provide:

UpdatedAffidavit

AnyAttachmentstotheAffidavitnotpreviouslyprovidedorthathavechanged,e.g.,FCCForm471,contract,invoices

PROCEDUREFOR FILINGREQUEST FOR OUSF FUNDING

(Reference:OAC165:59-3-68 and 165:59-3-70).

(1)FilewiththeOklahomaCorporationCommissionCourtClerk:

(a)Thecompleted Request for OUSF Funding,alongwith four (4) copies,mustbefiledwiththeOklahomaCorporationCommissionCourtClerk. The supporting documentation must be submitted to the OUSF Administrator.

(b)ThefilingfeeforfilinganapplicationonthePublicUtilityDivisiondocketisonehundreddollars($100)andwillbeapplicable tothese Requests for OUSF Funding.

(c)TheCommissionCourtClerk’sbusinesshoursarefrom8:00a.m.to4:30p.m.,MondaythroughFriday,exceptonStateholidays. TheCommission’sCashier,however,closesat4:00p.m.eachday,therebyprecludingthefilingofanewapplicationafter4:00p.m.,becausenewcausenumbersareassignedbytheCashieruponthepaymentofthefilingfee.

(d)TheCommissionCourtClerk’sofficeislocatedonthefirstflooroftheJimThorpeBuilding,room130. ThestreetaddressoftheJimThorpeBuildingis2101NorthLincoln, OklahomaCity, Oklahoma73105.

(2)A copy of the Request for OUSF Funding and one set of supporting documentation isrequired to be delivered to theState AttorneyGeneral (“AG”):

Dara Derryberry

Officeofthe OklahomaAttorneyGeneral

313NE21stStreet

OklahomaCity,OK73105

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SECTIONTWO

REQUIRED FUNDINGREQUEST FORMS ANDINSTRUCTIONS

(1)SectionFourcontainsacopyoftherequired Request for OUSF FundingFormthatmustbesubmittedwithyourcompletedocumentation whenrequestingfundingfromtheOUSF. Inaddition,thissectioncontainsaninstructionsheetforeachFormincludedinthissection.

(2)Each Request for OUSF Funding for a school, library, or healthcare entity (telemedicine) or a Request for Change in Fundingmust contain a completed Affidavit in Support of Request for Special Universal Services (“Affidavit”). Use the Affidavit designed for the specific type of entity (school, library, or healthcare facility) found at:

(3)Eacheligible service provider or eligible telecommunications carrier shouldrevieweachFormandreadcarefullytheinstructionsheetsforeachFormtoassurethattherequiredFormsarecompleteandaccompaniedbytherequiredsupportingdocumentation. PleasekeepinmindthatanyRequestforOUSFFundingmay be deniediftheappropriateFormsarenotusedorsaidFormsarenot determined to be complete.

SUPPORTINGWORKPAPERSANDDOCUMENTATION

Applicantsarerequiredtoprovideasufficientandcompetentlevelofsupportingworkpapersanddocumentationinordertofullyexplainthebasisoftherequestandtoshowthattheleveloffundingrequestedisaccurateandproperlycalculated. Support documents should be in “Word” and/or “Excel” formats, i.e., DOCX version of affidavits and Excel version of SUSF forms and attachments. PleasenotethatcertainsupportingdocumentationistobeprovideddirectlytothePUDandtheAGonthedaytheapplicationisfiled. Anyfilingthatfailstobeaccompaniedbyasufficientandcompetentlevelofsupportingdocumentationwillbedeemedtobeincompleteandmay result in a denial of some or all of the requested funding. Adetaileddiscussionoftherequiredsupport documentationis containedin theinstructionscontained ineachForm.

REQUIRED APPLICATIONFORM INSTRUCTIONS

TherequiredApplicationFormistheleaddocumentinyourapplicationpackageandprovidesgeneralinformationregardingthefundingsupportrequestaswellasservingasthedocumentthatwillbestampedwiththeCauseNumberrelatedtothefiling.

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SECTIONTHREE

OKLAHOMALIFELINEFUND (OLF) SERVICEPROGRAM

(Reference: OAC 165:59-9-3)

(1)The Oklahoma Lifeline Fund(OLF) is a programdesignedtooperateinconjunctionwiththeFederalLifelineprogram,toprovideamonthlycreditto the monthly bill of qualifying residential subscribers for basic local exchange service, in an amount equal to such amount as may be established by 17 O.S. § 139.105.

(2)InordertoqualifyfortheOklahoma Lifeline Service Program, acustomermustmeetall applicablerequirementsof47CFR§§54.400through54.422and/or 17 O.S. § 139.105.

(3)Each eligible local exchangetelecommunications service providershallfiletariffsimplementingaLifelineServiceProgramthat is consistentwiththisSubchapter.

(4)LifelineAssistanceshallnotbeavailableonaretroactivebasistothecustomers.

(5)Uponnotificationtotheeligiblelocal exchange telecommunicationsservice provider,thecreditwillbediscontinuedforcustomerswhonolongerqualifyforLifelineAssistance.

(6)LifelineServicebenefitsareapplicableonlytotheprimarylineatthecustomer’sprincipalresidence. AnapplicantforLifelineServicemayreportonlyoneaddress inthestateastheprincipal placeofresidence.

(7)AsaparticipantinLifelineAssistance,customerswillbeeligibletoreceiveTollRestrictionServiceatnocharge.

(8)Eacheligible local exchange telecommunicationsserviceproviderwithapprovedLifelineServicetariffsshalladvertisetheavailabilityoftheLifelineServiceProgramwithinits exchange(s) or serviceterritory on,at a minimum,anannualbasis.

(9)The wireless eligible local exchange telecommunications service provider must provide access to its own customer service department by dialing 611 from the wireless handset or have a toll free number for contacting the eligible local exchange telecommunications service provider programmed in the phone and clearly identified.

(10)All enrollments in any Lifeline Services from any outdoor mobile location or by door to door sales shall be governed by OAC 165:55-23-16.

(11)Any wireless handset provided in conjunction with the Lifeline Service must clearly and permanently identify the provider of the service.

(12)An eligible local exchange telecommunications service provider may not provide Lifeline Service purely by resale without a Commission order.

(13)An approved Lifeline tariff may not be modified without submitting the modification to the OLF Administrator at least fifteen (15) days prior to the effective date of the proposed change for the purpose of receiving a determination whether the modification is in the public interest. Unless the eligible local exchange telecommunications service provider receives written notification that its modification is NOT IN THE PUBLIC INTEREST within fifteen (15) calendar days after its submission, the submission is deemed to be in the public interest and may be implemented.

(14)The eligible local exchange telecommunications service provider shall utilize a third party verification system that has been approved by the OLF Administrator to verify the customer's identity and address, or obtain a waiver from the OLF Administrator from this requirement.

(15)The eligible local exchange telecommunications service provider must retain a copy of the signed application for Lifeline Service, and any recertification information for five (5) years.

(16)The eligible local exchange telecommunications service provider shall maintain a database sufficient to identify any duplicates among all companies associated with the eligible local exchange telecommunications service provider.

(17)Unless otherwise approved by Commission Order, any Lifeline plan offered by a wireless provider must comply with the minimum service standards for voice services detailed at 47 C.F.R. § 54.408.

(18)All marketing efforts must clearly identify the eligible local exchange telecommunications service provider actually providing the Lifeline Service.

(19)In addition to other remedies available to the Commission, violations of the marketing rules may result in a minimum of a thirty (30) days suspension of an eligible local exchange telecommunications service provider’s ability to sign up new customers and/or a fine as authorized by 17 O.S. §139.105 after notice and hearing.

(20)The eligible local exchange telecommunications service provider seeking reimbursement from the OLF for the provisioning of Lifeline services shall also note on the certified written statement obtained from the customer the name of the employee or representative who verified the customer's eligibility for Lifeline service and the type of documentation reviewed.

(21)Prior to obtaining money from the OLF, an eligible local exchange telecommunications service provider must show compliance with 17 O.S. § 139.105(E).

RECERTIFICATION(Reference:OAC165:59-9-5)

Each eligible local exchange telecommunications service provider, eligible to receive Lifeline support from the OLF and/or the federal Lifeline Fund shall, annually, require each end-user subscriber to recertify confirming their continued eligibility for the State or Federal Lifeline program. The eligible local exchange telecommunications service providershall retain a copy of the signed recertification form for three (3) years.

PROCEDURESFOR REQUESTINGREIMBURSEMENTFROM THEOLF(Reference:OAC165:59-9-25)

(1)Anyeligible local exchange telecommunications service provider with approvedLifelineServicetariffsmayapplytotheAdministratoror contracted agentoftheOLFforreimbursementoftheLifelineServiceProgramcreditsprovidedforresidentialbasiclocalservice.

(2)Uponreceiptofa“RequestforOLFFunding,”theAdministratoror contracted agentshallindependently evaluate and reviewtheRequestandsupportingdocumentationand,asappropriate,paytheapplicableamounttotheeligible local exchange telecommunications service provider, as provided in the Oklahoma Telecommunications Act.

(3)AtelecommunicationscarrierseekingreimbursementofeligibleLifelineServicesProgramcredits fromtheOLFshall:

(a)Filea“RequestforOLFFunding”withtheCommission’sCourtClerk.

(b)Concurrent with filing the Request for OLF Funding, the eligible local telecommunications service provider who is requesting funding from the OLF shall provide notice, which shall include the dollar amount of the request for lump sum and any recurring amounts, of the Request for OLF Funding to the OLF Administrator, the Oklahoma Attorney General, and to each contributing provider by providing an electronic copy of such notification to the OLF Administrator on the date the eligible local exchange telecommunications service provider files its Request for OLF Funding with the Court Clerk, for posting on the Commission website. The OLF Administrator will then place the notification on the Commission website within five (5) business days.

(4)An eligiblelocalexchangetelecommunicationsservice provider may not receive reimbursement fromtheOLFunlessitdemonstratesthatitsrateshavebeenreducedbyanamountequaltotheamountoftheLifelinepaymentsthatwerepreviouslyincludedintheratestructureoftheeligible local exchange telecommunications service provider. An eligible local exchange telecommunications service provider shallbeeligibleforsupportfromtheOLFforanyamountwhichisgreaterthantheamountwhichhasbeenpreviouslyincludedintheratestructureoftheeligible local exchange telecommunications service provider.

(5)The OLF Administrator shall independently review and determine the accuracy of the complete request and issue a Determination of the eligibility for funds, which details the amount of funding recoverable from the OLF, within 90 days. Simultaneously with the OLF Administrator advising the eligible local exchange telecommunications service provider and parties to the cause, the OLF Administrator shall file the written Determination with the Commission’s Court Clerk and post it to the Commission’s website.

(6)Any affected party may file a request for reconsideration within 15 days of the Determination being filed by the Administrator, by following the procedures in OAC 165:59-3-72.

(7)Any Request for Reconsideration will be process using the provisions set forth in OAC 165:59-3-72.

(8)The OLF Administratoror contracted agent shallensurethatallOLFfundshavebeenreceivedandareondepositinasufficientmannersoastopayrequestsforOLFFunding in accordance with the Oklahoma Telecommunications.The OLFAdministratoror contracted agent shallprovidetheapprovedfundingtotherequestingeligible local exchangetelecommunications service provider, consistent with the procedures in OAC 165:59-3-68.

(9)Any request for funds from the OLFwill be returned to therequesting party and deemed denied if the appropriate forms are notused orsaidforms are not completedin a satisfactory manner.

RECOVERYOFCONTRIBUTION

(Reference:OAC165:59-9-27)

Eachcontributing providertotheOLFmayrecoverits contributionsto the OLFconsistentwith17 O.S. § 139.105.TheOLFrecoveryreceivedbyeach eligible local exchange telecommunications service providershallbe subject to an annual true-up. Any over- or under-recovery of the Lifeline ServiceProgramcontributionsfortheprecedingyearshallbecarriedforwardforinclusion in the calculation for recoveryin theensuingyear.

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SECTION FOUR

PRIMARY UNIVERSAL SERVICES / REQUEST FOR OUSF FUNDING TEMPLATE

BEFORE THE CORPORATION COMMISSION OF OKLAHOMA