Service Provider Identification Number (SPIN) and Contact Information Form

FCC FORM 498

Pending Approval by OMB 3060-0824

Instructions for Completing the Service Provider
Identification Number and Contact Information Form
FCC Form 498 is used to collect contact, remittance, and payment information for service
providers that receive support from the federal universal service support mechanisms. For
greater flexibility, this form allows service providers to use the same information for all of
the support mechanisms or different contact and remittance information for each of the
four support mechanisms, or multiple contact and remittance information. Please report
any changes to this information on a revised FCC Form 498 to prevent any delays in
notification and the timeliness of disbursements.
I. Introduction
On May 8, 1997, the Federal Communications Commission (the Commission) released a
Report and Order on Universal Service in CC Docket No. 96-45 that established new
federal universal service support mechanisms, consistent with the universal service
provisions contained in section 254 of the Communications
Act of 1934, as amended.
The Commission appointed the Universal Service Administrative Company
(USAC) administrator of the federal universal service support mechanisms, including
High-Cost, Low-Income, Rural Health Care, and Schools and Libraries.
One of the functions of USAC is to provide a means for the billing, collection, and
disbursement of funds for all four support mechanisms.
Pursuant to 47 C.F.R. §§ 54.301, 54.303, 54.307, 54.309, 54.311, 54.407,
54.413, 54.515, 54.611, 54.702, 54.802, and 54.902, USAC must obtain information
relating to service provider name, address, telephone number, Federal Employee
Identification Number (Federal EIN or tax ID number), contact names and telephone
numbers, billing, and collection information.
To that end, the Commission and USAC have developed a Service Provider Identification
Number and Contact Information Form, FCC Form 498, to collect this information from
service providers that receive support from the High-Cost, Low-Income, Rural Health
Care, and Schools and Libraries Support Mechanisms.
This document provides instructions for completing the FCC Form 498. Each service
provider that receives federal universal service support under any of the four support
mechanisms must complete this form. First time applicants will be assigned a Service
Provider Identification Number (SPIN). This form will be used to collect the following
information: service provider name, address, phone numbers, e-mail addresses, contact
names, and billing and collection information. USAC will use this information to administer
the billing, collection, and disbursement operations of the federal universal service
programs.

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FCC Form 498 – Sept. 2009 Edition

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II. FILING REQUIREMENTS AND GENERAL INSTRUCTIONS
A.

Who Should File the FCC Form 498

All service providers that participate in the High-Cost, Low-Income, Rural Health
Care, or Schools and Libraries Universal Service Support Mechanisms must file FCC
Form 498 to receive disbursement payments.
Service Providers should complete an FCC Form 498 in order to:
•
•
•
•

Apply for a new SPIN.
Revise an existing FCC Form 498.
Consolidate, merge, or deactivate existing SPINs due to a merger, acquisition, or
consolidation of companies.
Deactivate a SPIN and end participation in the federal universal service support
mechanisms. High-Cost and Low-Income recipients must comply with 47 C.F.R. §
54.205 if relinquishing High-Cost or Low-Income federal universal service support.

USAC will rely on the data provided in this form to disburse federal universal service
support consistent with the specifications of the service provider. This form allows service
providers to specify which addresses and payment information to use for each of the
support mechanisms in which they participate. For example, service providers
participating in all four support mechanisms may use a single financial institution and
remittance contact for all support payments. Other service providers may wish to have
federal universal service support mechanism payments sent to different financial
institutions. Such service providers would follow directions provided below to specify a
separate remittance contact and financial institution information for each of the support
mechanisms in which they participate.
Further, the information in this form will enable certain service providers to offset
payments from the Schools and Libraries and/or Rural Health Care Support Mechanisms
against any federal universal service contribution obligations. Contributors are companies
that are obligated to make payments to federal universal service. Each contributor and
each contributor’s business unit should complete the FCC Form 498. For each contributor
or business unit, USAC will assign a number upon receipt of a complete and correct FCC
Form 498. Copies of the FCC Form 498 may be reproduced and completed for as many
business units as are providing service.
B.

When and Where to File

Service providers must submit the FCC Form 498 before support payments will be
authorized. Original applications must be sent to:

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FCC Form 498 – Sept. 2009 Edition

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USAC Customer Operations, Billing and Disbursements
Attn: FCC Form 498
2000 L Street, N.W. Suite 200
Washington, DC 20036
Revisions to FCC Form 498 can be filed electronically at:
http://www.Forms.universalservice.org
C.

Where to Get More Information

Please direct any questions about completing this form to USAC via:
Internet at: http://www.usac.org/forms
E-mail at: [email protected]
Telephone at: 888-641-8722 or Fax 888-637-6226

III. SPECIFIC INSTRUCTIONS
The following section describes the service provider information that should be provided
on the FCC Form 498.
A.
Form Overview
Indicate, by checking the appropriate box, the action being requested with the submission
of this form. For an original application, all fields must be completed. To initiate revisions,
all lines in Blocks 1-3 and 14-15 must be completed. FCC Form 498 is USAC’s official
record of contact and remittance information. Service providers, therefore, must keep the
information in this form current. Failure to maintain current information may affect the
timeliness of payment.
THE FOLLOWING 4 OPTIONS MUST BE CERTIFIED BY A COMPANY OFFICER:
1. Original Application for SPIN: Please check this box if this is the company’s initial
FCC Form 498.
2. Revision to Existing FCC Form 498 on file with USAC: Please check this box if this
is a revision to an existing FCC Form 498 on file with USAC. If it is a revision, please
include the company’s previously assigned SPIN.
3. Request for SPIN Merger/Consolidation: Please check this box to consolidate the
activity of multiple SPINs into one SPIN, or merge a SPIN into your SPIN due to an
acquisition or merger. Additional documentation is required. Please see Appendix A on
page 18 of the instructions for additional information.

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4. Request for SPIN deactivation: Please check this box to discontinue participation in
the federal universal service support mechanism. High-Cost and Low-Income recipients
must comply with 47 C.F.R. § 54.205 if relinquishing High-Cost or Low-Income federal
universal service support. Additional documentation is required. Please see Appendix A
on page 18 of the instructions for additional information.
Service Provider Identification Number (SPIN): Leave this field blank if this is the initial
submission of an FCC Form 498. USAC will process the form within seven to 10 business
days of receipt and will assign a SPIN to the company. Within 48 hours after processing
has been completed, USAC will notify the company of the assigned SPIN.
For all subsequent submissions of FCC Form 498 (e.g., revisions to original data), please
include your assigned SPIN. Revisions to previously filed information cannot be processed
without the SPIN.
FCC Form 499 Filer ID: Contributors to federal universal service must provide the FCC
Form 499 Filer ID (Telecom Relay Service (TRS) Company Code) as it appears on the
Telecommunications Reporting Worksheet FCC Form 499. This must be indicated for all
companies that are required to file the FCC Form 499.
B.

Block 1: General Company Information

Block 1 requires you to identify the legal name and address of the service provider.
Item (1) Company Name: Provide the full legal name of the company providing service
as it appears on articles of incorporation, registration, or other legal documents.
Item (2) Name Company Is Doing Business As (DBA) or Formerly Known
As (FKA): Provide the name currently used by the service provider, or if this form effects
a name change, provide the name formerly used.
Items (3, 4, 5, 6, & 7) Service Provider’s Address: Provide the service provider’s full
mailing address, street address or route number, city, state, and zip code. Do not include
a post office box. USAC will return any FCC Form 498 that uses a post office box.
C. Block 2: General Contact Information
Block 2 requires the contact information for the individual preparing this form. The General
Contact is the main point of contact for the service provider and for billing, collections, and
disbursement-related matters. The General Contact can change remittance information
for any of the four universal service support mechanisms. The General Contact is also the
service provider’s main point of contact for the e-file system (and for company-created
users of the e-file system), and may access additional forms for any of the four universal
service support mechanisms.

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Items (8, 9 10 & 11) General Contact Information: Provide the name, title, phone
number, and fax number for the person that should be contacted with questions regarding
the billing, collection, and disbursement of funds for the service provider. Only the
General Contact or an Officer of the company is permitted to make revisions to the FCC
Form 498, but the Officer listed in Block 15 must certify any revisions.
Items (12, 13, 14 15, 16, & 17) Address and E-Mail Address of General Contact:
Provide the General Contact’s full mailing address, street address or route number, city,
state, zip code, and e-mail address. Please do not use a post office box. USAC will return
any FCC Form 498 that uses a post office box. A confirmation notice will be sent to the email address listed in Block 2. The e-mail address must be specific to the General
Contact. Generic e-mail addresses are not accepted in this block. USAC will reject all
forms with a generic e-mail address.
D. Block 3: Federal EIN and DUNS Number
Block 3 requires the service provider’s Federal Employer Identification Number (Federal
EIN or tax ID number), business structure, and Dunn and Bradstreet Identification Number
(DUNS) number.
Item (18) Federal EIN: Enter the service provider’s Federal EIN. For companies required
to indicate their 499 Filer ID, the Federal EIN listed on the FCC Form 498 must match the
Federal EIN listed on the FCC Form 499.
Item (19) Business Structure: Check one of the three boxes indicating whether the
service provider is a corporation, partnership or other.
Item (20) DUNS: Enter the service provider’s nine digit DUNS number.
High-Cost Support Mechanism
E. Block 4: High-Cost Financial Institution and Remittance Information
Please complete this section only if your company receives support from the High-Cost
Support Mechanism. Block 4 requires financial institution and remittance information that
will be used to direct any High-Cost Support Mechanism payments and remittance
information. Financial institution information is required. Electronic payment of universal
service support payments is mandated by the Debt Collection Improvement Act of 1996,
Pub. Law 104-134, 110 Stat. 1321-358. If the remittance contact is the same as the
General Contact in Block 2, please check the box to indicate this in Block 4 and continue
with lines 30 to 33.
Item (21) High-Cost Remittance Company Name: Provide the name of the company
that will receive payment for High Cost Support Mechanism payments if different than the
company indicated in item 1.

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Items (22 & 23) High-Cost Remittance Contact Name and Title: Provide the name and
title of the High-Cost remittance contact person who will answer questions regarding the
remittance of High-Cost Support Mechanism payments to the service provider. All HighCost remittance statements will be sent to the High-Cost remittance contact’s attention.
Items (24, 25, 26, 27, & 28) Address of High-Cost Remittance Contact: Provide the
full mailing address, street address or route number, city, state, and zip code of the HighCost remittance contact. Please do not use a post office box. USAC will return any FCC
Form 498 that uses a post office box. This is the address to which High-Cost Support
Mechanism remittance statements will be sent.
Item (29 & 30) Telephone and Fax Number of High-Cost Remittance Contact: Provide
the telephone, extension and fax number of the High-Cost Support Mechanism remittance
contact.
Check the box after Item 30 if you are requesting mailed paper copy statements instead of
electronic remittance statements. If you do not check this box, your remittance statements
will be sent to the e-mail address in Item 34.
Item (31) Name of High-Cost Remittance Financial Institution: High-Cost Support
Mechanism payments are made via Automatic Clearing House (ACH), and financial
institution information is required to process such payments. If you do not provide this
information, you will not receive payment.
Items (32 & 33) High-Cost Remittance Financial Institution Account Number and
Transit Number for ACH Payments: Provide the ACH financial institution account
number and financial institution transit number. Please be sure that the transit number is
nine digits. If you do not provide this information, you will not receive payment.
Item (34) E-mail Address of High-Cost Remittance Contact: Provide the e-mail
address of the High-Cost Support Mechanism remittance contact. This e-mail address will
be used for your electronic remittance statements and outreach.
F. Block 5: Company Contact for High-Cost Support Mechanism
Please complete Block 5 only if a service provider receives support from the High-Cost
Support Mechanism. Block 5 requires the service provider’s High-Cost Support
Mechanism contact information. If the High-Cost Support Mechanism contact information
is the same as that presented in Block 2, please check the box to indicate this in Block 5
and continue onto the next block. Otherwise, please complete the contact information in
Block 5. The General Contact or an Officer of the company is permitted to make
revisions to the FCC Form 498, but the Officer listed in Block 15 must certify any
revisions.
Items (35, 36, 37, 38, 39, 40 & 41) Name and Address of High-Cost Support
Mechanism Contact: Provide the High-Cost Support Mechanism company contact

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person’s name, title, mailing address, street address or route number, city, state, and zip
code. Please do not use a post office box. USAC will return any FCC Form 498 that uses
a post office box. USAC will send all High-Cost Support Mechanism correspondence to
this address. The High-Cost Support Mechanism contact should be an employee of the
service provider. This High-Cost Support Mechanism contact is authorized to request
additional information from the High-Cost Support Mechanism information related to this
SPIN.
Items (42, 43, & 44) Phone Number, Fax, and E-Mail Address of High-Cost Support
Mechanism Contact: Provide the phone number, fax number, and e-mail address of the
High-Cost Support Mechanism contact person who will receive correspondence and
answer questions regarding the High-Cost Support Mechanism.
Low-Income Support Mechanism Payments
G. Block 6: Low-Income Financial Institution and Remittance Information
Please complete this section only if your company receives support from the Low-Income
Support Mechanism. Block 6 requires financial institution and remittance information that
will be used to direct any Low-Income Support Mechanism payments and remittance
information. Financial institution information is required. Electronic payment of universal
service support payments is mandated by the Debt Collection Improvement Act of 1996,
Pub. Law 104-134, 110 Stat. 1321-358. If the remittance contact is the same as the
General Contact in Block 2, please check the box to indicate this in Block 6. Continue in
Block 6 with lines 53 to 56.
Item (45) Low Income Remittance Company Name: Provide the name of the company
that will receive payment for Low Income Support Mechanism payments if different than
the company indicated in item 1.

Items (46 & 47) Low-Income Remittance Contact Name and Title: Provide the name
and title of the Low-Income Support Mechanism remittance contact person that will
answer questions regarding the remittance of Low-Income Support Mechanism payment
to the service provider. All Low-Income Support Mechanism remittance statements will be
sent to the remittance contact person’s attention.
Items (48, 49, 50, 51, & 52) Address of Low-Income Remittance Contact:
Provide the full mailing address, street address or route number, city, state, and zip code
of the Low-Income Support Mechanism remittance contact for the service provider. Please
do not use a post office box. USAC will return any FCC Form 498 that uses a post office
box. This is the address to which Low-Income Support Mechanism remittance statements
will be sent.

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Item (53 & 54) Telephone and Fax Number of Low-Income Remittance Contact:
Provide the telephone number, extension and fax number of the Low-Income Support
Mechanism remittance contact.
Check the box after item 54 if you are requesting mailed paper copy statements instead of
electronic remittance statements. If you do not check this box, your remittance statements
will be sent to the e-mail address in Item 58.
Item (55) Name of Low-Income Remittance Financial Institution: Low-Income Support
Mechanism payments are made via electronic Automatic Clearing House (ACH), and
financial institution information is required to process such payments. If you do not
provide this information, you will not receive payment.
Items (56 & 57) Low-Income Remittance Financial Institution Account Number and
Transit Number for ACH Payments: Provide the ACH financial institution account
number and financial institution transit number. Please be sure that the transit number is
nine digits. If you do not provide this information, you will not receive payment.
Item (58) E-mail Address of Low-Income Remittance Contact: Provide the e-mail
address of the Low-Income Support Mechanism remittance contact. This e-mail address
will be used for your electronic remittance statements and outreach.
H. Block 7: Company Contact for Low-Income Support Mechanism
Please complete this block only if your company participates in the Low-Income Support
Mechanism. Block 7 requires completion of the Low-Income Support Mechanism contact
information. If the Low-Income Support Mechanism contact information is the same as
that presented in Block 2, please check the box in Block 7 and continue onto the next
block. Otherwise, please complete the Low-Income Support Mechanism contact
information in Block 7. The General Contact or an Officer of the company is permitted to
make revisions to the FCC Form 498, but the Officer listed in Block 15 must certify any
revisions.
Items (59, 60, 61, 62, 63, 64 & 65) Name, Title, and Address of Service
Provider’s Low-Income Support Mechanism Contact: Provide the Low-Income
Support Mechanism contact person’s name, title, mailing address, street address or route
number, city, state, and zip code. Please do not use a post office box. USAC will return
any FCC Form 498 that uses a post office box. USAC will send all Low-Income Support
Mechanism correspondence to this address. The Low-Income Support Mechanism
contact should be an employee of the service provider. This Low-Income Support
Mechanism contact is authorized to request additional Low-Income Support Mechanism
information related to this SPIN.
Items (66, 67, & 68) Phone Number, Fax, and E-mail Address of
Low-Income Support Mechanism Contact: Provide the phone number, fax number, and
e-mail address of the Low-Income Support Mechanism contact person who will receive

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Low-Income Support Mechanism correspondence and answer questions regarding the
Low-Income Support Mechanism.

I. Block 8: High-Cost and Low-Income Study Area Code (SAC)/SPIN
Association
Companies that do not receive support from the High-Cost and Low-Income
Mechanisms and do not have SAC assignments may proceed to Block 9.
For providers that receive support from the High-Cost and Low-Income Support
Mechanisms, please list the Study Area Codes (SACs) you wish to have associated with
the Service Provider Identification Number (SPIN) data.
Box One (1): Check this box if you are not changing the existing SAC data currently on
file with USAC. If you check this box, you may proceed to Block 9.
Box Two (2): Check this box if you wish to update the SAC data currently on file with
USAC. Be sure to include all of the SACs you wish to associate with the SPIN.
SAC: Please indicate the six (6) digit SAC.
Incumbent: Check this box if the SPIN associated with this SAC is listed with USAC as
an Incumbent Carrier for that area.
Competitive: Check this box if the SPIN associated with this SAC is listed with USAC as
a Competitive Carrier for that area.
If your organization has more than twenty two (22) SAC codes, please submit an
additional sheet with those codes to USAC.
Rural Health Care Support Mechanism
J. Block 9: Rural Health Care Financial Institution and Remittance
Information
It is mandatory that all Rural Health Care Support Mechanism disbursement
payments must be offset against the service provider’s federal universal
service contribution obligations, for telecommunications carriers that do not
meet the de minimis standard.
Please complete this section only if your company receives support from the Rural Health
Care Support Mechanism. Block 9 requires financial institution and remittance information
that will be used to direct any Rural Health Care Support Mechanism payments and

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remittance information. Financial institution information is required. Electronic payment of
universal service support payments is mandated by the Debt Collection Improvement Act
of 1996, Pub. Law 104-134, 110 Stat. 1321-358. In accordance with 47 C.F.R § 54.611,
USAC will offset the service provider's Rural Health Care Support Mechanism payments
against the service provider’s universal support contribution obligation. If the remittance
contact is the same as the General Contact in Block 2, please check the box to indicate
this in Block 9 and continue with lines 76 to 79.
Items (69) Rural Healthcare Remittance Company Name: Provide the name of the
company that will receive payment for Rural Healthcare Support Mechanism payments if
different than the company indicated in item 1.
Items (70 & 71) Rural Health Care Remittance Contact Name and Title:
Provide the name and title of the remittance contact person who will answer questions
regarding the remittance of Rural Health Care Support Mechanism payments to the
service provider. All Rural Health Care Support Mechanism remittance statements will be
sent to the remittance contact person’s attention.
Items (72, 73, 74, 75 & 76) Address of Rural Health Care Remittance
Contact: Provide the full mailing address, street address or route number, city, state, and
zip code of the Rural Health Care Support Mechanism remittance contact. Please do not
use a post office box. USAC will return any FCC Form 498 that uses a post office box.
This is the address to which Rural Health Care Support Mechanism remittance statements
will be sent.
Item (77 & 78) Telephone and Fax Number of Rural Health Care Remittance Contact:
Provide the telephone number, extension and fax number of the Rural Health Care
Support Mechanism remittance contact.
Check this box after Item 78 if you are requesting mailed paper copy statements instead
of electronic remittance statements. If you do not check this box, your remittance
statements will be sent to the e-mail address in Item 82.
Item (79) Name of Rural Health Care Remittance Financial Institution: Rural Health
Care Mechanism payments are made via electronic Automatic Clearing House (ACH), and
financial institution information is required to process such payments. If you do not
provide this information, you will not receive payment.
Items (80 & 81) Rural Health Care Remittance Financial Institution Account Number
and Transit Number for ACH Payments: Provide the ACH financial institution account
number and transit number. Please be sure that the transit number is nine digits. If you do
not provide this information, you will not receive payment.
Item (82) E-mail Address of Rural Health Care Remittance Contact: Provide the e-mail
address of the Rural Health Care Support Mechanism remittance contact. This e-mail
address will be used for your electronic remittance statements and outreach.

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K. Block 10: Company Contact for Rural Health Care Support Mechanism
Please complete this section only if your company receives support from the Rural Health
Care Support Mechanism. Block 10 requires completion of the Rural Health Care Support
Mechanism contact information. If the Rural Health Care Support Mechanism contact
information is the same as that presented in Block 2, please check the box to indicate this
in Block 10 and continue onto the next block. Otherwise, please complete the Rural Health
Care Support Mechanism contact information in Block 10. The General Contact or an
Officer of the company is permitted to make revisions to the FCC Form 498, but the
Officer listed in Block 15 must certify any revisions.
Items (83, 84, 85, 86, 87, 88 & 89) Name, Title, and Address of Rural Health Care
Support Mechanism Contact: Provide the Rural Health Care Support Mechanism
contact person’s name, title, mailing address, street address or route number, city, state,
and zip code. Please do not use a post office box. USAC will return any FCC Form 498
that uses a post office box. USAC will send all Rural Health Care Support Mechanism
correspondence to this address. The Rural Health Care Support Mechanism contact
should be an employee of the service provider. This contact is authorized to request
additional Rural Health Care Support Mechanism information related to this SPIN.
Items (90, 91 & 92) Phone, Fax, and E-mail Address of Service Provider’s
Rural Health Care Support Mechanism Contact: Provide the phone number, fax
number, and e-mail address of the Rural Health Care Support Mechanism contact person
who will receive correspondence and answer questions regarding the Rural Health Care
Support Mechanism.
Schools and Libraries Support Mechanism Payments
L. Block 11: Schools and Libraries Financial Institution and Remittance
Information
Please complete this section only if your company receives support from the Schools and
Libraries Support Mechanism. Block 11 requires financial institution and remittance
information that will be used to direct any Schools and Libraries Support Mechanism
payments and remittance information. Financial institution information is required.
Electronic payment of universal service support payments is mandated by the Debt
Collection Improvement Act of 1996, Pub. Law 104-134, 110 Stat. 1321-358. If the
remittance contact is the same as the General Contact in Block 2, please check the box to
indicate this in Block 11 and continue with lines 99 to 102.
Item (93) Schools and Libraries Remittance Company Name: Provide the name of the
company that will receive payment for Schools and Libraries Support Mechanism
payments if different than the company indicated in item 1.

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Items (94 & 95) Schools and Libraries Remittance Contact Name and Title:
Provide the name and title of the Schools and Libraries Support Mechanism remittance
contact person who will answer questions regarding the remittance of Schools and
Libraries Support Mechanism payments to the service provider. All Schools and Libraries
Support Mechanism remittance statements will be sent to the remittance contact person’s
attention.
Items (96, 97, 98, 99 & 100) Address of Schools and Libraries Remittance
Contact: Provide the full mailing address, street address or route number and city, state,
and zip code of the Schools and Libraries Support Mechanism remittance contact. Please
do not use a post office box. USAC will return any FCC Form 498 that uses a post office
box. This is the address to which Schools and Libraries Support Mechanism remittance
statements will be sent.
Item (101 & 102) Telephone and Fax Number of Schools and Libraries Remittance
Contact: Provide the telephone number, extension and fax of the Schools and Libraries
Support Mechanism remittance contact.
Check the box after item 102 if you are requesting mailed paper copy statements instead
of electronic remittance statements. If you do not check this box, your remittance
statements will be sent to the e-mail address in Item 106.
Item (103) Name of Schools and Libraries Remittance Financial Institution: Schools
and Libraries Support Mechanism payments are made via electronic Automatic Clearing
House (ACH), and financial institution information is required to process such payments.
If you do not provide this information, you will not receive payment.
Items (104 & 105) Schools and Libraries Remittance Financial Institution Account
Number and Transit Number for ACH Payments: Provide the ACH financial institution
account number and transit number. Please be sure that the transit number is nine digits.
If you do not provide this information, you will not receive payment.
Item (106) E-mail Address of Schools and Libraries Remittance Contact:
Provide the e-mail address of the Schools and Libraries Support Mechanism remittance
contact. This e-mail address will be used for your electronic remittance statements and
outreach.
M. Block 12: Company Contact for Schools and Libraries Support Mechanism
Please complete this block only if your company receives support from the Schools and
Libraries Support Mechanism. Block 12 requires completion of the Schools and Libraries
Support Mechanism contact information. If the Schools and Libraries Support Mechanism
contact information is the same as that presented in Block 2, please check the box in
Block 12 and continue onto the next block. Otherwise, please complete the contact
information in Block 12. The General Contact or an Officer of the company is permitted to

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make revisions to the FCC Form 498, but the Officer listed in Block 15 must certify any
revisions.

Items (107, 108, 109, 110, 111, 112, & 113) Name, Title, and Address of Service
Provider Schools and Libraries Support Mechanism Contact: Provide the Schools
and Libraries Support Mechanism contact person’s name, title, mailing address, street
address or route number, city, state, and zip code. Please do not use a post office box.
USAC will return any FCC Form 498 that uses a post office box. USAC will send all
Schools and Libraries Support Mechanism correspondence to this address. This contact
should be an employee of the service provider. This contact is authorized to request
additional Schools and Libraries Support Mechanism information related to this SPIN.
Items (114, 115, & 116) Phone, Fax, and E-Mail Address of Service Provider
Schools and Libraries Support Mechanism Contact: Provide the phone number, fax
number, and e-mail address of the Schools and Libraries Support Mechanism contact
person who will receive correspondence and answer questions regarding the Schools and
Libraries Support Mechanism.
N. Block 13: Offsetting Disbursement Payments against Federal Universal
Service Contribution Obligations
This block only relates to telecommunications carriers participating in the Schools and
Libraries and Rural Health Care Support mechanisms. In accordance with section 54.515
of the Commission’s rules regarding Schools and Libraries Support Mechanism payments,
a telecommunications carrier may choose to offset its Schools and Libraries Support
Mechanism payment against its federal universal service contribution. In accordance with
section 54.611 of the Commission’s rules regarding Rural Health Care Support
Mechanism payments, a telecommunications carrier MUST offset its Rural Health Care
Support Mechanism payment against its federal universal service contribution. A
telecommunications carrier must have an FCC Form 499 Filer ID number to offset its
Schools and Libraries or Rural Health Care Support Mechanism payments against its
federal universal service contribution. To obtain an FCC Form 499 Filer ID number, visit
www.universalservice.org/forms and select FCC Form 499. You do not need an FCC
Form 499 Filer ID number to be issued a SPIN.
Item (117) Offset Indicator: The service provider must indicate (by checking
the box or leaving it blank) whether or not it is requesting to have its Schools and Libraries
Support Mechanism invoice payments offset against the provider’s federal universal
service contribution obligations.
O. Block 14: Principal Communications Business Types
Block 14 requires the selection of a Principal Communications Business Code.
Principal Communications Business: Mark the boxes that describe the
telecommunications activity or activities of the organization. If more than one is

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appropriate, please label the activities in order of importance to the company’s business,
e.g., enter a “1” in the box for the type of entity that represents the most important part of
the organization’s business, enter a “2” in the box that represents the next most important
part, etc. Select no more than 5 of the following categories:
Code
CAP/CLEC

Description
(Competitive Access Provider/Competitive Local Exchange Carrier)
Competes with incumbent local exchange carriers (LECs) to provide
local exchange services, or telecommunications services that link
customers with interexchange facilities, local exchange networks, or
other customers, other than Coaxial Cable providers.

Cellular/PCS/SMR (Cellular, Personal Communications Service, or Specialized Mobile
Radio Service Provider) Primarily provides wireless
telecommunications services (wireless telephony). This category
includes all providers of real-time two-way switched voice services
that interconnect with the public switched network, including providers
of prepaid phones and public coast stations interconnected with the
public switched network.

Coaxial Cable

Uses coaxial cable (cable TV) facilities to provide local exchange
services or telecommunications services that link customers with
interexchange facilities, local exchange networks, or other customers.

Incumbent LEC

(Incumbent Local Exchange Carrier) Provides local exchange
service. An incumbent LEC generally is a carrier that was at one time
franchised as a monopoly service provider or has since been found to
be an incumbent LEC. See 47 U.S.C. § 251(h).

Interexchange
Carrier (IXC)

Provides long distance telecommunications services substantially
through switches or circuits that it owns or leases.

Internet Service
Provider

Provides access to the Internet.

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Interconnected
VOIP

Provides “interconnected VoIP service” as that term is defined in 47
C.F.R. § 9.3.

Local Reseller

Provides local exchange or fixed telecommunications services by
reselling services of other carriers.

Non-Traditional
Provider (NTP)

Company that does not provide telecommunications services.

Operator Service
Provider

Serves customers needing the assistance of an operator to complete
calls, or needing alternate billing arrangements, such as collect
calling.

Paging and
Messaging

Provides wireless paging or wireless messaging services. This
category includes the provision of paging and messaging services by
resale.

Payphone Service
Provider

Provides access to telephone networks through pay telephone
equipment, special teleconference rooms, etc. Payphone service
providers are also referred to as pay telephone aggregators.

Prepaid Card

Provides prepaid calling card services by selling prepaid calling cards
to the public, to distributors, or to retailers. Prepaid card providers
provide consumers the ability to place long distance calls without
presubscribing to an interexchange carrier or using a credit card.
Prepaid card providers typically resell the toll service of other carriers
and determine the price of the service by setting the price of the card,
assigning personal identification numbers (PINs) and controlling the
number of minutes that the card can be used for.

Private Service
Provider

Offers telecommunications to others for a fee on a non-common
carrier basis. This would include a company that offers excess
capacity on a private system that it uses primarily for internal
purposes. This category does not include SMR or Satellite Service
Providers.

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Satellite Service
Provider

Provides satellite space segment or earth stations that are used for
telecommunications service.

Shared-Tenant
Service Provider /
Building LEC

Manages or owns a multi-tenant location that provides
telecommunications services or facilities to the tenants for a fee.

SMR (dispatch)

Primarily provides dispatch services and mobile services other than
wireless telephony. While dispatch services may include
interconnection with the public switched network, this category does
not include carriers that primarily offer wireless telephony. This
category includes LTR dispatch or community repeater systems.

Toll Reseller

Provides long distance telecommunications services primarily by
reselling the long distance telecommunications services of other
carriers.

Wireless Data

Provides mobile or fixed wireless data services using wireless
technology. This category includes the provision of wireless data
services by resale.

P. Block 15: Authorized Contact Signature
Block 15 requires the signature of the Company Officer authorized to certify that the data
set forth in the FCC Form 498 is true, accurate, and complete. Incomplete information or
incorrect filling of this form will result in it being returned to the company and the form will
not be processed. Persons willfully making false statements on this form can be punished
by fine or forfeiture, under the Communications Act, as amended, 47 U.S.C. secs.502,
503(b), or fine or imprisonment under Title 18 of the United States Code, 18 U.S.C. Sec.
1001. In addition, Block 15 requires the date, printed name, title, and e-mail address of
the Company Officer certifying the form. The e-mail address will be used for return
confirmation and related correspondence only. Generic e-mail addresses are not
accepted in this block. USAC will reject all forms with a generic e-mail address.
Companies may provide a General Contact in Block 2 separate from the Company Officer.
This individual will be able to retrieve the FCC Form 498 information on file with USAC as

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well as be given access to USAC’s on-line filing system. This person will also be able to
input new SPIN data for Officer certification.
Incomplete information or incorrect filing of the form will result in it being returned
to the company and the form will not be processed.
Notice on e-certification: Authorized Officers and Preparers may be granted access to
the on-line FCC Form 498 system. This will allow service providers to manage their FCC
Form 498 data on-line. For certification, access requirements and additional information,
please visit https://forms.universalservice.org, or contact USAC via telephone at 888-6418722. Save time, avoid problems. File electronically at https://forms.universalservice.org.
Notice: The Federal Communications Commission (the Commission) has designated the
Universal Service Administrative Company (USAC) as administrator of federal universal
service. One of the functions of USAC is to provide a means for billing, collection, and
disbursement of funds for the various federal universal service support mechanisms. In an
effort to implement these requirements and obligations, the Commission has adopted this
collection of information. Pursuant to the Commission’s rules, 47 C.F.R. §§ 54.301,
54.303, 54.307, 54.309, 54.311, 54.407, 54.413, 54.515, 54.611, 54.702, 54.802, and
54.902, USAC must obtain information relating to service provider name and address,
telephone number, Federal EIN, contact names and telephone numbers, billing, collection,
and disbursement information. Each service provider receiving federal universal service
support from the High-Cost, Low-Income, Rural Health Care, or Schools and Libraries
Support Mechanisms, should complete the FCC Form 498. USAC will use this information
in administering the billing, collection, and disbursement operations of federal universal
service.
Reminder: You are not required to respond to a collection of information sponsored by the
federal government, and the government may not conduct or sponsor this collection,
unless it displays a currently valid Office of Management and Budget (OMB) control
number. This collection has been assigned an OMB control number of 3060-0824.
The Commission is authorized under the Communications Act of 1934, as
amended, to collect the information we request in this form. We will use the information
that you provide for federal universal service billing, collection, and disbursement
purposes. If we believe there may be a violation or potential violation of a state or federal
statute, or of a Commission regulation, rule, or order, your form may be referred to the
federal, state, or local agency responsible for investigating, prosecuting, enforcing, or
implementing the statute, rule, regulation, or order. In certain cases, the information in
your form may be disclosed to the Department of Justice, a court, or other governmental
or adjudicative bodies when (a) the Commission; or (b) any employee of the
Commission; or (c) the United States government, is a party to a proceeding before the
body or has an interest in the proceeding. In addition, consistent with the Communications
Act of 1934, the Commission regulations and orders, the Freedom of Information Act, 5
U.S.C. § 552, or other applicable law, information provided in or submitted with this form
or in response to subsequent inquiries may be disclosed to the public.

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If you owe a past due debt to the federal government, the information you provide also
may be disclosed to the Department of the Treasury Financial Management Service, other
federal agencies, and/or your employer to offset your salary, IRS tax refund, or other
payments to collect that debt. The Commission also may provide this information to these
agencies through the matching of computer records where authorized.
If you do not provide the information we request on the form, the Commission may delay
processing you application, or may return you application without action.
This Notice is required by the Paperwork Reduction Act of 1995, P.L. 104-13, 44 U.S.C.
Section 3501 et seq. We have estimated that each response to this collection of
information will take, on average, 1.5 hours. Our estimate includes the time to read the
instructions, look through existing records, gather and maintain the required data, and
actually complete and review the form or response. If you have any comments on this
estimate, or how we can improve the collection and reduce the burden it causes you,
please write to the Federal Communications Commission, AMD-PERM, Washington, D.C.
20554, Paperwork Reduction Project (3060-0824). We also will accept your comments via
Internet if you send them to [email protected]. Please DO NOT SEND COMPLETED FORMS
TO THIS ADDRESS.

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Appendix A:
SPIN Merger/Consolidation Requirements.
To successfully process a Merger/Consolidation request, USAC requires the following
information:
9 Copies of sale, acquisition or merger documentation indicating the date of sale,
clearly demonstrating the surviving organization’s unfettered right to all SPIN data
and activity.
9 Only the first and last page (signature page) of the FCC Form 498 is required for
SPINS that will be impacted by a merger/consolidation request.
9 A complete FCC Form 498 for the SPIN that will be the replacement/surviving
SPIN.
9 A federal W-9 form indicating the Federal EIN (or Tax ID number).
9 Updated FCC Form 499 Filer ID information (where applicable).

SPIN Deactivation Requirements.
To successfully process a SPIN Deactivation, USAC requires the following information:
9 A brief cover letter explaining the deactivation, and any supporting documents.
9 Only the first and last page (signature page) of the FCC Form 498 is for a SPIN
being deactivated.
9 Updated FCC Form 499 Filer ID information (where applicable).

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