Connect America Fund - High Cost Portal Filing

Non-Public OMB 3060-1228

High Cost Universal Service

Broadband Information to be Submitted to Online Portal

(Note: This is a representative description of the information to be collected via the online portal and is not intended to be a visual representation of what each applicant will see).

Item Number	Field Description	Purpose/Instructions
1	Carrier Name	This is the name of the carrier submitting this form. May be auto-generated by system based on other information submitted.
2	Submission Year	This is the year for which the submission is associated. This is auto-filled by the system unless multiple filing years are still open.
3	Carrier Holding Company Name	Name of holding company or common control entity. Portal may allow a drop-down menu with choices based on FCC and USAC holding company information but allow users to enter another name if necessary. May be auto-generated by the system based on other information submitted.
4	Data Contact Name	Name of the person who prepared the submitted data
5	Data Contact Phone Number	Phone number of the person who prepared the submitted data
6	Data Contact Phone Number, extension	Phone number extension of the person who prepared the submitted data
7	Data Contact E-mail address	Email address of the person who prepared the submitted data
8	Study Area Code(s)	Study Area codes applicable to data filed.
9	Type of Carrier	The type of carrier (e.g., CAF II recipients electing model-based support, Rate of Return). Will be auto-generated by the system based on other information submitted.
10	State	The state or states for which the carrier is making a filing.
11	Location ID	A number that uniquely identifies the location served in the study area. May be generated automatically by the system.
12	Census Block Code	The census block code of the location. Will be auto-generated by system based on submitted latitude/longitude of location.
13	Latitude of Location	Latitude of the location to which service the provider has made service available. .
14	Longitude of Location	Longitude of the location to which service the provider has made service available.
15	Location Address – Number & Street	Number and street address of the location.
16	Location Address-City	City associated with the street address of the location
17	Location Address-State	2 letter postal abbreviation of the state associated with the street address of the location
18	Location Address-Zip Code	5-digit ZIP code associated with the street address of the location
19	Location Address-No Postal Address Available	In those cases where postal address is not available, alternate address information.
20	Number of units	If the location is a building with multiple units, such as an apartment or office building, enter the number units at that location. Each unit should be a separate housing unit or small business location and will be counted as an individual location.
21	Bandwidth/Speed of Service Available	Upload and download speed/bandwidth of service available at that location. Speed must be at or above defined tiers (e.g., 4/1, 10/1, 25/3) for each carrier type. Carrier will enter code for each tier, not actual bandwidth. For Alaska Plan rate-of-return carriers, carriers enter Alaska Plan specific code for speed tier with backhaul.
22	Date of Deployment	The date on which service was made available to the location.
23	Milestone Information	Auto-filled by system based on location filing indicating whether the ETC has met its required buildout milestones.
24	Officer Certification regarding data veracity	An officer of the carrier must certify prior to the filing deadline each year, that the information filed is accurate to the best of the officer’s knowledge
25	Officer Certification regarding milestones and public interest obligations.	An officer of the carrier must certify prior to the filing deadline each year, that the carrier has met its applicable deployment milestones and/or that its service meets its applicable public interest requirements.
26	Officer Certification regarding upgraded locations	An officer of the carrier must certify that, by the end of 2017, at least five percent of the nationwide total of the carrier’s reported locations must be locations that previously lacked 4/1 Mbps service. (only carriers electing Phase II support and only for filing due on March 1, 2018)
27	Officer Certification Regarding Capital Expenditures	An officer of the carrier must certify that the capital expenditure cost to build to any low-cost location was $5,000 or more. ACS only.
28	Officer Certification Regarding Partially Served Locations	An officer of the carrier must certify that it does not serve any of the locations it proposes to serve in its list of geocoded locations filed by October 1, 2018. ACS only one time certification.
29	Certifying Official Name	Name of certifying official.
30	Certifying Official Title	Job title of certifying official
31	Certifying Official Phone Number	Phone number of the certifying official
32	Certifying Official Phone Number, Extension	Phone number extension of the certifying official
33	Certifying Official Email Address	Email address of the certifying official
34	Date Signed	The date on which the filing is certified. Auto-generated
35	Funded block or extremely high cost census block	Phase II ETC Accepting Model-Based Support only. Would be auto-generated by the system.
36	Type of technology	For example, copper or fiber. Phase II Auction Winner and Remote Areas fund recipients only.
37	Substitute Location	Whether the location is a substitute location in a partially-served or low-cost census block. ACS only.
38	Supporting Document Type (upload document)	Supporting document provided to substantiate network build-out. Only rural broadband experiment recipients.
39	498 ID	Pre-populated identifier used to by USAC to store remittance, payment, and contact information for service providers that receive support from the universal service programs – High Cost, Lifeline, Rural Health Care, and Schools and Libraries.
340	Feedback	Optional user-submitted feedback about filing and user experience
41	Evidence of Deployment	Upload field for carriers to submit evidence demonstrating that they have met their deployment obligations. Rural Broadband Experiment Recipients only.
42	Notes	Optional field for carrier to provide notes or messaging for their own use or for USAC.
44	Fiber/Microwave Network Map	Upload field for carriers to submit shapefile using a line feature class depicting fiber/microwave middle-mile network. Alaska Plan recipients only.
45	Nodes	Upload field for carriers to submit node information (latitude and longitude) as a delimited text file, i.e., CSV. Alaska Plan recipients only.

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