Download:
pdf |
pdfOMB 3060-0806
FCC Form 471
Approval by OMB
3060-0806
Schools and Libraries Universal Service
Services Ordered and Certification Form
Estimated Average Burden Hours Per Response: 4 hours
Instructions for Completing the
Schools and Libraries Universal Service
Services Ordered and Certification Form (FCC Form 471)
CONTENTS
I. PURPOSE OF FORM ............................................................................................................................ 1
II. GENERAL INSTRUCTIONS ................................................................................................................ 1
A. Who Must File ................................................................................................................................. 1
B. Who Can Provide E-rate Eligible Services ..................................................................................... 3
C. When, Where, and How Many FCC Forms 471 to File .................................................................. 3
D. Assistance in Completing This Form .............................................................................................. 4
III. SPECIFIC INSTRUCTIONS ................................................................................................................. 4
A. Block 1: Billed Entity Information ................................................................................................. 4
B. Block 4: Discount Calculation Worksheets .................................................................................... 6
C. Block 5: Discount Funding Request(s) ......................................................................................... 12
D. Block 6: Certifications and Signature ........................................................................................... 20
I.
PURPOSE OF FORM
The FCC Form 471 is filed to request discounts on eligible services for eligible schools, libraries, and
consortia of those entities under the E-rate program (more formally known as the schools and libraries
universal service support program). Starting in Funding Year 2015, the FCC Form 471 must be
completed online. The FCC Form 471 must reference services that were competitively bid with an FCC
Form 470 posted on the USAC website for at least 28 days before the FCC Form 471 is filed, unless you
are specifically exempted by FCC rules from the FCC Form 470 posting requirement. The 28-day
waiting period begins after the FCC Form 470 is posted on the USAC website, www.usac.org/sl, or after
a request for proposal (RFP) is made publicly available, whichever is later. This 28-day waiting period
must occur before you may execute any contracts for contracted services, as applicable; before you select
your service provider for tariffed or month-to-month services; and before you submit your completed
FCC Form 471. It is possible that an FCC Form 470 posted in a prior funding year may be used where
such a form resulted in a multi-year contract. (See FCC Form 470 Instructions.)
II.
GENERAL INSTRUCTIONS
A.
Who Must File
All participants are required to file a FCC Form 471 application. Specifically, every entity responsible
for making payments directly to a service provider, the “billed entity,” must file an FCC Form 471
application. Even if several billed entities together file a single FCC Form 470, each billed entity must
file a separate FCC Form 471. An entity that receives a bill, but does not make payments to the service
provider on that bill, is not a billed entity, and therefore should not be filing an FCC Form 471
application.
Page 1
FCC Form 471 Instructions – October 2014
OMB 3060-0806
While all applicants must file an FCC Form 471, some applicants seeking funding for a multi-year
contract in Funding Year 2015 can fill out a streamlined application in subsequent funding years. These
applicants will be required to provide only basic information identifying the applicant, confirm that the
funding request is a continuation of an FRN from a previous year based on a multi-year contract, and
identify and explain any changes to their application, such as changes in the discount rate, the
membership of a consortium, or the services ordered. This simplified application process will be
available to any applicant, beginning in Funding Year 2016, that has: (1) submitted a complete FCC
Form 471, in Funding Year 2015 or later, for the first funding year they are seeking E-rate support under
a multi-year contract that is no longer than five years; and (2) any changes in the requested services or to
the terms and conditions under which those services are provided are within the scope of the establishing
FCC Form 470 and the applicable contract.
Eligibility of schools
For purposes of the schools and libraries universal service support program, schools must meet the
statutory definition of elementary and secondary schools found in the No Child Left Behind Act of 2001,
20 U.S.C. § 7801(18) and (38). This definition says that an elementary school is a non-profit
institutional day or residential school, including a public elementary charter school that provides
elementary education, as determined under state law. See 47 C.F.R. § 54.500 and 20 U.S.C. § 7801(18).
A secondary school is a non-profit institutional day or residential school, including a public secondary
charter school, that provides secondary education, as determined under state law, and does not include
schools that offer education beyond grade 12. See 47 C.F.R. § 54.500; 20 U.S.C. § 7801(38). In
addition, schools operating as for-profit businesses or who have endowments exceeding $50 million are
not eligible. See 47 C.F.R. § 54.501(a)(3).
Eligibility of libraries
Libraries must meet the statutory definition of library or library consortium found in the Library Services
and Technology Act, 20 U.S.C. § 9121 et seq. (1996) (LSTA), and must be eligible for assistance from a
state library administrative agency under that Act. A library includes: “(1) a public library; (2) a public
elementary school or secondary school library; (3) an academic library; (4) a research library, which for
the purposes of this definition means a library that: (i) makes publicly available library services and
materials suitable for scholarly research and not otherwise available to the public; and (ii) is not an
integral part of an institution of higher education; and (5) a private library, but only if the state in which
such private library is located determines that the library should be considered a library for purposes of
this definition.” See 47 C.F.R. § 54.500. A library's eligibility for universal service funding also
depends on its funding as an independent entity. Only libraries whose budgets are completely separate
from any schools’ (including, but not limited to, elementary and secondary schools, colleges, and
universities) shall be eligible to receive discounted services under the universal service support
mechanism. See 47 C.F.R. § 54.501(b)(2). For example, an elementary school library would only be
eligible to receive discounted services if its budget were completely separate from the elementary school.
If its budget were not completely separate from the elementary school, the elementary school library
would not be eligible for support independent from the school with which it is associated. Libraries
operating as for-profit businesses shall not be eligible for discounts. See 47 C.F.R. § 54.501(b)(3).
Eligibility of consortia and library consortia
A consortium is “any local, statewide, regional, or interstate cooperative association of schools and/or
libraries eligible for E-rate support that seeks competitive bids for eligible services or funding for eligible
services on behalf of some or all of its members.” See 47 C.F.R. § 54.500.
Page 2
FCC Form 471 Instructions – October 2014
OMB 3060-0806
A library consortium is “any local, statewide, regional, or interstate cooperative association of libraries
that provides for the systematic and effective coordination of the resources of school, public, academic,
and special libraries and information centers, for improving services to the clientele of such libraries.”
See 47 C.F.R. § 54.500.
B.
Who Can Provide E-rate Eligible Services
Eligibility of Service Providers
To provide eligible services under this program, service providers must secure a SPIN from USAC and
certify that they will comply with program rules.
C.
When, Where, and How Many FCC Forms 471 to File
When:
The FCC Form 471 must be filed during a specific application window each year. In general, the
application filing window opens about six months before the start of the funding year and is open for
about two and a half months. Applicants should check the USAC website, www.usac.org/sl, or contact
the USAC Client Service Bureau (CSB) at 1-888-203-8100 to obtain the filing window dates.
All materials associated with the FCC Form 471 must be filed by 11:59 p.m. ET on or before the last day
of the FCC Form 471 application filing window in order for the request to receive consideration as inside
the window. It is your responsibility to check the USAC website or contact CSB to obtain the
announcement of the filing window dates.
The required materials are:
•
•
The FCC Form 471 itself;
The Block 6 certification pages of the FCC Form 471 with the signature of the authorized
person (online with PIN or on paper).
Note that while the FCC Form 471 can be filed anytime during the application filing window, the filing
of any FCC Form 471 must be done at least 28 days after the FCC Form 470 is posted, if one is required.
The FCC Form 470 Receipt Notification Letter will identify the earliest date – the Allowable Vendor
Selection/Contract Date – on which you may choose a service provider and, if applicable, execute a
contract, and sign and submit an FCC Form 471. The Allowable Vendor Selection/Contract Date will
also be indicated on the FCC Form 470 posted on the USAC website.
All FCC Forms 471 and certifications submitted by the close of the application filing window are
considered as if they had arrived on the same day, and have priority over those postmarked after the
closing date of the window.
Where:
You must complete and submit the FCC Form 471 by filing the form online on USAC’s Schools and
Libraries program website at www.usac.org/sl.
After you have completed the form, you may submit your FCC Form 471 certifications online if you have
a Personal Identification Number (PIN). If the authorized person does not yet have a PIN, one will be
automatically issued once USAC successfully processes a paper certification for any FCC Form 470,
471, or 486. The PIN can be used by that authorized person for any forms filed on behalf of that Billed
Page 3
FCC Form 471 Instructions – October 2014
OMB 3060-0806
Entity. When you submit your certifications online with the PIN, you will receive a confirmation so that
you can be assured that your submission has met any filing deadlines.
If the authorized person has forgotten the PIN and needs USAC to issue a replacement PIN, contact CSB
at 1-888-203-8100. The Change or Disable Applicant PIN tool can be used to disable a PIN, change a
PIN or provide a new e-mail address if the original e-mail address has changed. Mailing addresses
cannot be changed, but you can provide a new e-mail address. The only way to change the mailing
address is to file a new form or form certification on paper and include your mailing address in the
authorized person's mailing address fields.
How Many:
You may file more than one FCC Form 471 and, in fact, you must file separate applications for Category
One (Internet Access, Telecommunications Services, and/or Voice Services) and Category Two (Internal
Connections, Managed Internal Broadband Services, and/or Basic Maintenance of Internal Connections).
This separation allows USAC to process applications more quickly. If there are questions about your
application, decisions on both Category One and Category Two requests may be delayed.
D.
Assistance in Completing This Form
You will be assisted in the process by step-by-step prompts when completing this form online.
Applicants are also urged to consult the Reference Area of USAC’s Schools and Libraries program
website for guidance in completing this form. Complete program information is also available by
contacting CSB via e-mail using the “Submit a Question” link on the USAC’s Schools and Libraries
program website, via fax at 1-888-276-8736, or via toll-free telephone at 1-888-203-8100.
III.
SPECIFIC INSTRUCTIONS
“You” refers throughout this form to the Billed Entity – the party actually paying bills for the eligible
schools and libraries listed in this application form.
Applicant’s Form Identifier – Applicants may assign a unique number or letter of your own devising to
facilitate communication with us about THIS particular FCC Form 471. This Applicant’s Form Identifier
can be very simple; for example, if you are filing three FCC Forms 471, you might label them “A,” “B,”
and “C.” The Applicant’s Form Identifier can also be descriptive, such as “Internet.” Choose identifiers
that suit your own record keeping needs.
A.
Block 1: Billed Entity Information
Block 1 of FCC Form 471 asks you for your address and other contact information, if not already on file.
Prior to completing this form, you must have a Billed Entity Number. If you do not have one, contact the
USAC CSB at 888-203-8100. Much of the information in Block 1 will appear in the designated fields
after the Billed Entity Number is entered.
Item 1 – Lists the name of the Billed Entity. As the Billed Entity, you may be an individual school, a
school district that is the Billed Entity for its schools, a library (outlet/branch, system), or a consortium of
those entities. A Billed Entity may also be a city, a state, or an entity created solely to participate in this
universal service discount mechanism, provided that the entity actually pays the bills for the service to
the service provider. The billed entity itself does not have to be eligible for discounts.
Page 4
FCC Form 471 Instructions – October 2014
OMB 3060-0806
Item 2 – The Funding Year will appear automatically on your application. Funding years begin on July
1 and end on the following June 30. For example, Funding Year 2015 runs from July 1, 2015 to June 30,
2016.
Items 3a – Your Billed Entity Number (BEN) is a unique number assigned to your organization or
institution by USAC as a means of identifying you every time you file an application or otherwise
communicate with us. If you have applied for funds in previous years, or have been identified in an
application filed on your behalf, you should have already been assigned this number. If you do not have
a record of your Billed Entity Number, or if you believe you have never been assigned such a number,
please contact CSB at 1-888-203-8100. (See also “Assistance in Completing this Form” above.)
Items 3b – The FCC Registration Number is a unique number assigned to your organization or
institution by the FCC as a means of identifying you every time you file an application or otherwise
communicate with us. Note that if you share a tax ID with other entities, you will also share a single
FCC Registration Number. If you have applied for funds in previous years you should have already been
assigned this number. If you do not have a record of your FCC Registration Number or if you believe
you have never been assigned such a number, please contact the FCC Registration Number website at
https://apps.fcc.gov/coresWeb/publicHome.do, or call the FCC Registration Number help line at 1-877480-3201 (Mon.-Fri. 8 a.m.-6 p.m. ET).
Items 4a-4c – Provide the full mailing address, whether a street address, Post Office Box number, or
route number of the Block 1 entity. In addition, please provide your telephone number with area code
and extension and your fax number.
Item 5a – Check the one box that best describes the type of application you are filing. If you are filing as
an individual school, you should check the first box. If you are filing as a public or non-public school
district or local education agency (LEA), you should check the second box, even if this application only
contains funding requests for a single school from within your school district. If you are filing as a
library (outlet/branch, system, or library consortium as defined under LSTA), you should check the third
box. If you are filing as a consortium, you should check the fourth box. (You may be a consortium of
schools, libraries, or some combination of the above, which may include eligible and ineligible entities.)
If you check the fifth box, you must also check one or more of the three choices provided in this item –
all public schools/districts in the state, all non-public schools in the state, and/or all libraries in the state –
and indicate the two-letter state code. Please note that if your application represents SOME but not ALL
of any of these three types of entities, you should NOT check the statewide application box.
In addition, if you are a consortium that includes non-governmental entities ineligible for universal
service support, you should note that you cannot negotiate pre-discount prices below tariff rates for
interstate services from incumbent local telephone companies.
Item 5b – Check all boxes that apply to you or any of the entities included in this specific form.
Item 6a – Provide the name of the person who should be contacted with questions about this application.
This person should be able to answer questions regarding the information included on this form and the
services you request.
Items 6b-6f – Provide your correspondence address. USAC will use this address to mail correspondence
about this form, including the Funding Commitment Decision Letter. If the contact person’s address
Page 5
FCC Form 471 Instructions – October 2014
OMB 3060-0806
information is the same as Item 4 above, check the appropriate box instead, or if you are using a
consultant, you may indicate that the correspondence should go to their address. You must enter an
email address, which will be used by USAC for all contact regarding this application. Also provide the
contact person’s phone and number and fax number. Finally, in Item 6f, you may choose to provide an
alternate telephone number, address, or an alternate contact name that we may use during
holiday/vacation/summer periods. Item 6f should contain only the name of the alternate contact person –
if appropriate – and an alternate phone number, fax number, and/or e-mail address.
Item 6g – If a consultant is assisting you with your E-rate process, provide the Consultant Registration
Number (CRN). A consultant is any non-employee of the entity applying for funding that assists in
filling out the application materials for a fee. “Non-employee” includes contractors or others who are
employed by the entity on a contract or short-term basis who do not receive a W-2 application from the
entity filling out the application. Once you enter the CRN, the system will provide the contact
information for that consultant. If the consultant does not have a Consultant Registration Number, the
consultant can contact CSB to obtain one at 1-888-203-8100. (See also “Assistance in Completing this
Form” above.)
Blocks 2 and 3: [Reserved]
B.
Block 4: Discount Calculation Worksheets
The basic discount calculation is performed at the school district level. Individual schools within a
school district and library outlets/branches within a library system do not calculate individual discounts.
Independent schools not part of a public or non-public school district or library system will calculate
their discounts based on the own student population. Independent libraries, not part of a library system,
will calculate their discounts based on the NSLP data for the school district in which they are located.
• All the individual schools in a public or non-public school district use the school district average
discount.
• Library systems and library outlets/branches use the NSLP information of the public school
district in which the main branch of the library is located, though they calculate the urban/rural
status based on the location of their own library outlets.
• A consortium or statewide application uses a simple average of the discounts of its member
entities. The consortium includes the school district calculation for each school district entity
number that will be featured in any worksheet on the form.
• Individual schools applying as if they were a school district or as if they were a consortium – for
example, diocesan schools – use the school district or consortium model, respectively. If they
are applying as a consortium, each individual school will be treated as a consortium member and
will complete a school district calculation for that individual school in addition to the entityspecific information in Item 7a.
To assist you in completing the Block 4, there are two tools that applicants can use to save time.
•
•
Page 6
Copy Block 4: The Copy Block 4 feature allows users to copy the Block 4 data from another
FCC Form 471. In Funding Year 2015, this functionality may be limited to pulling information
from this Funding Year FCC Forms 471.
Block 4 Bulk Upload: This allows users to upload Block 4 information from a spreadsheet,
which will then populate the fields on the FCC Form 471. More information is available from
USAC’s website.
FCC Form 471 Instructions – October 2014
OMB 3060-0806
(a)
Percent of students
eligible for National
School Lunch Program
< 1……………………..
1-19……………………
20-34…………………..
35-49…………………..
50-74…………………..
75-100………………….
DISCOUNT MATRICES
Category One
schools and libraries
discount matrix
Discount level
Category Two
schools and libraries
discount matrix
Discount level
Urban
discount
Rural
discount
Urban
discount
Rural
discount
20
40
50
60
80
90
25
50
60
70
80
90
20
40
50
60
80
85
25
50
60
70
80
85
Voice Services (Category One) are subject to a 20 percentage point reduction each year beginning with
Funding Year 2015. For example, if you are eligible for a 70 percent discount for Category One services,
your discount on Voice Services will be 50 percent for FY2015 and 30 percent for FY2016.
Item 7 – All Entities in the School District or Library System
For each school district or library system, you will need to provide a list of all of the members of that
school district or library system, regardless of whether they are receiving service on this application or
not.
•
Enter the School District or Library System BEN, and the system will return the name of the
school district or library system.
If you are filing as a consortium, you will need to complete a worksheet for each of your consortium
members (school districts, library systems, or independent schools and/or libraries) listing all of the
individual schools in each school district and all of the library outlets/branches in each library system.
These worksheets will then be combined by the online system to generate the consortium level worksheet
and discount calculation.
Item 7a – List of all Schools and Libraries in the School District or Library System
Instructions for Schools and School Districts:
Please provide a complete list of all of the entities in your school district or library system, including
Non-Instructional Facilities (NIF), even if they are not receiving service on this application. For each
individual school or NIF in the school district, provide:
•
•
Page 7
Entity number, and the system will then provide the individual school or NIF name.
National Center for Education Statistics (NCES) code: The NCES is the primary federal entity
FCC Form 471 Instructions – October 2014
OMB 3060-0806
•
•
•
•
•
•
Page 8
for collecting and analyzing data related to education. A school or school district’s NCES
number can be found at: http://nces.ed.gov/globallocator/. Some entities, such as private schools,
non-instructional facilities, or new schools or schools under construction may not have codes.
Private schools can request to be added to the NCES database at:
http://nces.ed.gov/surveys/pss/privateschoolsearch/school_requestform.asp
Urban or Rural status: The FCC’s definition of rural is new for Funding Year 2015. The system
will automatically provide the Urban/Rural status of the entity based on the physical address for
that entity in USAC’s systems. If you disagree with that determination, you may override this
result; however, such actions will cause a delay in the processing of your application. To verify
the entity’s address in USAC’s systems, please contact the USAC CSB at 888-203-8100. A
separate lookup tool is also available on USAC’s website, http://www.usac.org/sl. A school
district that that has more than 50% of its schools in a rural areas that meet the statutory
definition of eligibility for E-rate support will qualify for the additional rural discount (NIFs are
not included in this determination).
Indicate if this is a non-instructional facility (NIF): A NIF is a school district building that has
not been designated by the state as a school. Examples of NIFs include, but are not limited to,
administrative buildings, school bus barns and garages, offices, and facilities associated with
athletic activities that are separate from any school.
State school IDs (LEA code and school code): Please provide this information which is assigned
by the state where the school is located.
Indicate the total number of students in the school and indicate if the entry is an estimate (this
entry should be the same for each entity within a single school). The student count in Item 7a is
used to determine the number of students for the purposes of Category Two funding and should
not be confused with the student count for calculating the discount. Students who attend
multiple schools, such as those that attend vocational schools part-time, may be counted by both
schools in Item 7a in order to ensure appropriate local area networks (LANs) and wireless local
area networks (WLANs or Wi-Fi networks) deployment for both buildings.
Indicate if the number of students in the school is based on an estimate: If it is impossible to
calculate the number of students in a school because of new construction or another valid reason,
applicants are permitted to make a reasonable estimate of the number of students who will be
attending a school during a particular funding year and seek support for Category Two services
for the estimated number of students. However, if an applicant overestimates the number of
students who enroll in that school, it must return to USAC by the end of the next funding year
any Category Two funding in excess of that to which it was entitled based on the actual number
of enrolled students.
Indicate if an alternative discount mechanism was used to calculate the number of students
eligible for NSLP. Schools may use mechanisms other than actual school lunch participation to
determine a school's level of need, as long as those mechanisms are based on, or do not exceed,
the same measure of poverty used by NSLP. For further information, see Alternative Discount
Mechanisms on the usac.org/sl website. Examples of alternative discount mechanisms include:
- Surveys: Starting in FY 2015, applicants may no longer extrapolate results of surveys
conducted to determine the number of students eligible for NSLP.
- Community Eligibility Option: Schools increasingly have the option of participating in the
CEP, which neither requires nor permits schools to collect individual student eligibility
information. A school is eligible for community eligibility if at least 40 percent of its
students are “directly certified,” i.e., identified for free meals through means other than
household applications (for example, students directly certified as receiving benefits from the
Supplemental Nutrition Assistance Program). To compensate for low-income families not
FCC Form 471 Instructions – October 2014
OMB 3060-0806
•
•
reflected in the direct certification data, schools apply a standard, national factor (multiplier)
to their identified student population in order to determine the total percentage of meals for
which they will be reimbursed by the USDA. Each school that participates in CEP must
determine on a school-by-school basis the number of students to be counted as eligible for
NSLP for purposes of E-rate. In making that determination, a school should multiply the
percentage of directly certified students by the CEP national multiplier. This percentage
should then be applied to the total number of students attending the school as their home
school to determine the number of students eligible for NSLP for purposes of E-rate at that
school location, provided that the number of eligible students may not exceed the number of
students attending the school. If the student count calculation results in a fraction, applicants
must round up (if 0.5 or above) or down (if less than 0.5) to the closest whole number.
School Attributes: Indicate if the school serves a special population (such as pre-kindergarten,
Head Start, adult education, or juvenile justice) or if it is an Educational Service Agency,
includes dormitory facilities, serves tribal students, or is charter school. Indicate all that apply.
For each school, the system will then calculate the Category Two School Budget and display
both the pre-discount and post-discount amounts. NIFs do not qualify for their own Category
Two budget. Starting in Funding Year 2015, the FCC made a significant change in the way that
funding for Category Two services is allocated. Schools in districts that seek Category Two
funding during Funding Years 2015 or 2016 will be eligible to request E-rate discounts on
purchases of up to $150 (pre-discount) per student for Category Two services over a five-year
period. It is important to note that this amount is before the Category Two discount has been
applied (pre-discount). Therefore, schools at the highest Category Two discount rate of 85
percent will be eligible for up to $127.50 per student. Schools with a lower discount rate will
qualify for less. The Commission also established a pre-discount funding floor which will ensure
that all schools qualify for a minimum of $9,200. If an applicant receives funding for Category
Two in Funding Year 2015 or 2016, the five year budget will apply in the remaining funding
years, in lieu of the existing “two-in-five” rule. Applicants may choose to spend their budget in
one year, or may spread their purchases across the five funding years. If the E-rate program
provides commitments up to the applicant’s five-year Category Two budget in the first year, and
the school’s enrollment does not increase, the applicant will not receive any Category Two
funding commitments in the subsequent four funding years. Finally, note that the budget is set
on a per school basis and is not shared within the school district. For further information about
Category Two Applicant Budgets, please check the USAC website or contact CSB at 1-888-2038100.
Instructions for Libraries and Library Systems:
Please provide a complete list of all of the library outlet/branches in your library system, including NonInstructional Facilities, even if they are not receiving service on this application. For each individual
library or non-instructional facility (NIF) in the library system, provide:
•
•
•
Page 9
Entity number, and the system will then provide the individual library or NIF name.
Federal-State Cooperative System (FSCS) code: This is the identification code assigned by
NCES to libraries and library systems. The FSCS for public libraries is a cooperative program
between the federal government and the states, whose data on public libraries is received from
The Institute of Museum and Library Services (IMLS). A library or library system’s FSCS code
can be found at http://nces.ed.gov/surveys/libraries/librarysearch/.
Urban or Rural status: The FCC’s definition of rural is new for Funding Year 2015. The system
FCC Form 471 Instructions – October 2014
OMB 3060-0806
•
•
•
•
•
will automatically provide the Urban/Rural status of the entity based on the physical address for
that entity in USAC’s systems. If you disagree with that determination, you may override this
result; however, such actions will cause a delay in the processing of your application. To verify
the entity’s address in USAC’s systems, please contact the USAC CSB at 888-203-8100. A
separate lookup tool is also available on USAC’s website, http://www.usac.org/sl. A library
system that that has more than 50% of its outlets/branches in a rural areas that meet the statutory
definition of eligibility for E-rate support will qualify for the additional rural discount (NIFs are
not included in this determination). Note that even though libraries use the NSLP data from the
school district in which the main branch is located, it derives its own urban/rural status based on
the location of the library system’s outlets/branches. This may result in the library system
qualifying for a rural discount even though the school district does not.
Indicate if this is a non-instructional facility (NIF): A NIF is a library building without public
areas. Examples of non-instructional facilities on library property include, but are not limited to,
administrative buildings, bookmobile garages, interlibrary loan facilities, and library technology
centers.
Indicate the total square footage (including non-public areas): This is the area on all floors
enclosed by the outer walls of the library. Include all areas occupied by the library, including
those areas off-limits to the public. This does not include any spaces outside the library
building’s outer walls, such as patios and parking lots.
Indicate if this is the main branch of the library system. If so, provide the Billed Entity number
of the school district in which the main branch of the library system is located.
Library Attributes: Indicate if the library is a public, private, academic, research, or tribal library.
Also indicate if the library is a bookmobile or kiosk. Check all that apply.
For each library, the system will then calculate the Category Two School Budget and display
both the pre-discount and post-discount amounts. NIFs do not qualify for their own Category
Two budget. Starting in Funding Year 2015, the FCC made a significant change in the way that
funding for Category Two services is allocated. Libraries that seek Category Two funding
during Funding Years 2015 or 2016 will be eligible to request E-rate discounts on purchases of
up to $2.30 per square (pre-discount) for Category Two services over a five-year period. It is
important to note that this amount is before the Category Two discount has been applied (prediscount). Therefore, libraries at the highest Category Two discount rate of 85% will be eligible
for up to $1.96 per square foot. Libraries with a lower discount rate will qualify for less. The
Commission also established a pre-discount funding floor which will ensure that libraries with
less than 4,000 square feet qualify for a minimum of $9,200. If an applicant receives funding for
Category Two in Funding Year 2015 or 2016, the five year budget will apply in the remaining
funding years, in lieu of the existing “two-in-five” rule. Applicants may choose to spend their
budget in one year, or may spread their purchases across the five funding years. If the E-rate
program provides commitments up to the applicant’s Category Two budget in the first year, and
the library’s square footage does not increase, the applicant will not receive any Category Two
funding commitments in the subsequent four years. Finally, note that the budget is set on a per
library basis and is not shared within the library system. For further information about Category
Two Applicant Budgets, please check the USAC website or contact CSB at 1-888-203-8100.
Item 7b – School District Discount Calculation
For each school district entity number that will be featured on the form, provide the following
information:
Page 10
FCC Form 471 Instructions – October 2014
OMB 3060-0806
•
•
•
•
The school district name and BEN will be populated from Item 7.
Total number of students in the school district is used to determine the district-wide discount
calculation and should include all of the students in the school district as a whole, counting each
student only once. This number should not be confused with the number of students listed on a
school by school basis for the purposes of Category Two funding in Item 7a. If any students in
the school district attend more than one school, this number will not equal the sum of the student
counts in Item 7a. This is because that item allows students to be at each of the schools that they
attend. In Item 7b, students that attend multiple schools should only be counted one time.
o Note that USAC provides an optional online worksheet to assist applicants with
completing Item 7b. This optional worksheet allows you to provide school-level
information that will then be summed by the system to provide your total student and
total student NSLP numbers.
Total number of students in the school district eligible for the National School Lunch Program
(NSLP).
o Each school that participates in Community Eligibility Program (CEP) must determine
on a school-by-school basis the number of students to be counted as eligible for NSLP
for purposes of E-rate. In making that determination, a school should multiply the
percentage of directly certified students by the CEP national multiplier. This percentage
should then be applied to the total number of students attending the school as their home
school to determine the number of students eligible for NSLP for purposes of E-rate at
that school location, provided that the number of eligible students may not exceed the
number of students attending the school. If the student count calculation results in a
fraction, applicants must round up (if 0.5 or above) or down (if less than 0.5) to the
closest whole number.
The system will then calculate the percentage of students in the school district eligible for NSLP
and will display the appropriate discount rates based on the NSLP data and the urban/rural status
of the district’s schools or library system’s branches/outlets.
Item 8 – Connectivity
All applicants filing as a school, school district, library or library consortium must complete the survey
questions in Item 8a-8f for school district or library system referenced in Item 7. If you are filing for an
individual school or library that is not part of a district or library system, complete the information for
that individual school or library.
Consortia and Statewide applicants do not complete these questions.
Instructions for Schools and School Districts:
Item 8a – Internet access for schools
• Provide the speed of the Internet access.
Item 8c – Wide Area Networking for schools
• Provide the number of schools in the school district that have Wide Area Networking
connections scalable to 10 Gbps.
Instructions for Libraries and Library Systems:
Page 11
FCC Form 471 Instructions – October 2014
OMB 3060-0806
Item 8b – Internet access for libraries
• Provide the number of libraries that are part of the library system.
• Provide the number of libraries that serve a population of less than 50,000.
• For the libraries that serve a population of less than 50,000, provide the speed of their Internet
access.
• Provide the number of libraries that serve a population of 50,000 or greater.
• For the libraries that serve a population of 50,000 or greater, provide the speed of the Internet
access.
Item 8d – Wide Area Networking for libraries
• Provide the number of libraries in the library system that have Wide Area Networking
connections scalable to 10 Gbps.
Instructions for All Applicants
Item 8f – Local Area Networks for schools and libraries
• Provide the number of schools or libraries that have Local Area Network/Wireless Local Area
Network (LAN/WLAN) for each sufficiency of coverage indicated.
Item 8g – Insufficient LAN/WLAN capacity and coverage for schools and libraries
• If any of your answers in Item 8f indicated that your LAN/WLAN capacity and coverage were
less than completely sufficient, indicate the reason(s) below. If you check Other, please provide
a short explanation.
Item 9 – Consortium or Statewide Discount Calculation
If you selected Consortium or Statewide Application in Item 5a of this form, the system will have
prompted you to complete Item 7, 7a and 7b for each consortium member. Once you have completed
entering those preparatory worksheets, the system will then display your consortium discount calculation.
There is no applicant data entry in this item. The system will display:
• Name and Billed Entity Number of the Consortium member
• The Category One discount for the member entity from the Discount Matrices
• The Category Two discount for the member entity from the Discount Matrices
At the bottom of the table, the system will sum the member discounts and count the number of
consortium members. It will also display the consortium discount (the simple average) for both Category
One and Category Two services.
C.
Block 5: Discount Funding Request(s)
Block 5 asks you to provide information about the eligible services that you have ordered, their cost, and
the discount you are requesting based on the entities to receive service. The following information will
highlight the features of Block 5.
You will complete one Block 5 for each Funding Request. In general, you should complete a separate
Funding Request for:
• Each service provider identified by a unique Service Provider Identification Number (SPIN) that
will be providing you with service.
• Each separate contract (but not necessarily the individual service within that contract, as long as
they are the same service type, e.g., Internal Connections Other than Basic Maintenance).
Page 12
FCC Form 471 Instructions – October 2014
OMB 3060-0806
•
•
•
•
Each service type provided by the same provider. Check the Eligible Services List and any
updates on the USAC website to identify the service type.
Any voice services, so that the appropriate discount reduction can be applied. The online
application system will not allow you to mix voice and non-voice services in a single funding
request.
Long distance voice service (if, for example, your long distance service is billed separately from
your local phone service on a bill from a different service provider).
Services ordered based on different FCC Forms 470 or that qualify for an exemption from the
FCC Form 470 requirement. Services corresponding to each FCC Form 470 must be reported on
separate Funding Requests with the relevant FCC Form 470 Application Numbers. This includes
services ordered from the same service provider for the same service type if the order is based on
different FCC Forms 470.
You may request discounts only for products and services delivered in the relevant funding year.
Recurring services must be delivered between July 1 and June 30 of the funding year. Non-recurring
services must generally be delivered between July 1 and the September 30 following the close of the
funding year. Starting in Funding Year 2015, applicants seeking Category Two non-recurring services
are permitted to seek support for services purchased on or after April 1, three months prior to the start of
funding year on July 1. For more information, please refer to the Service Delivery section on the USAC
website.
Note that if you are seeking support on multi-year contracts, you may request funding only for that
portion of the contract that is delivered in the relevant funding year.
Ineligible costs: You may not seek support for ineligible services, entities, and uses, nor should you
inflate your funding request beyond what you are able to substantiate as your likely costs during the
funding year. Block 5 will guide you through deducting any ineligible costs from your total cost of
services before calculating your discount request. If you have any questions about whether a service
is eligible for support, please check the Eligible Services List on the USAC website or contact CSB
at 1-888-203-8100.
Signed contracts: You MUST have a signed contract or written legally binding agreement for all
services you order on your FCC Form 471 except:
• Tariffed services: Telecommunications services that you purchase at prices regulated by
your state regulatory commission and/or the FCC, for which you do not have a signed,
written contract.
• Month-to-Month Services: Month-to-month services for which you do not have a signed,
written contract. Your billing arrangement signifies that you are receiving your services on a
month-to-month basis.
• State Master Contracts: A signed state master contract between a state and a service
provider meets the FCC’s signed contract requirement. There may be additional state master
contract and/or local or state procurement requirements.
Note: You must file an FCC Form 470 and seek competitive bids for non-contracted tariffed or month-tomonth services each funding year, unless the services are part of a multi-year contract or are exempt from
the FCC Form 470 filing requirement.
No FCC Form 470 is required for:
Page 13
FCC Form 471 Instructions – October 2014
OMB 3060-0806
•
•
Business-class Internet access services. Starting with Funding Year 2015, certain
commercially available business-class Internet access services are exempt from the
requirement to post an FCC Form 470. Please see the USAC website for more information.
Preferred master contracts. Starting with Funding Year 2015, contracts designated by the
Wireline Competition Bureau of the FCC as preferred master contracts are exempt from the
requirement to post an FCC Form 470. Please see the USAC website for more information.
Item-by-Item Instructions
Funding Request Number (FRN) – USAC’s online system assigns a unique number to each funding
request.
Optional Applicant FRN Identifier – You may use this space to assign a unique name or code of your
own devising to facilitate communication with us about THIS particular funding request. Choose
identifiers that suit your own record keeping needs.
Item 10 – If this is a duplicate funding request (e.g., of an FRN from this or another funding year that is
not yet approved, under appeal, etc.), check this box and enter the original FRN in the space provided.
Item 11 – Check the correct service type for the service(s) listed on this funding request. You may check
only ONE service type. Please consult the Eligible Services List and any updates on the USAC website
or contact CSB at 1-888-203-8100. The online system will not allow you to include both Category One
and Category Two funding requests on the same application. Combining both Categories of Service on a
single application will cause funding delays.
Applicants seeking support for voice services must use a separate FRN from other eligible services.
Voice services are subject to a yearly 20 percentage point reduction beginning with Funding Year 2015.
Combining voice and non-voice services in a single FRN would cause delays in processing if USAC had
to separate out the services during the application review process.
Item 12 – Provide only ONE of the following:
•
•
•
Item 12a: The 15-digit FCC Form 470 Application Number of the FCC Form 470 in which the
services ordered here were sought. If you filed the FCC Form 470, this number appears on your
FCC Form 470 Receipt Notification Letter.
Item 12b: Check this box to indicate that this funding request is for an eligible commercially
available business-class Internet access service exempt from the requirement to post an FCC
Form 470.
Item 12c: Check this box to indicate that this funding request is for an eligible preferred master
contract exempt from the requirement to post an FCC Form 470.
Item 13 – Enter the 9-digit SPIN for the service provider that will provide service(s) on this funding
request. You must provide a valid SPIN for the service provider indicated in Item 14 below. Each
service provider should give you its SPIN on request. You may refer to the View SPIN information tool
of the website for service provider contact information. A service provider who does not have a SPIN
must file an FCC Form 498 to obtain one. The FCC Form 498 and Instructions can be downloaded from
the Forms area of the USAC website.
Item 14 – The online system will provide the full legal name of the Service Provider Identification
Number entered in Item 13.
Page 14
FCC Form 471 Instructions – October 2014
OMB 3060-0806
Item 15 – Provide the appropriate contract information for this service.
•
•
•
•
•
Item 15a – If this funding request is for a non-contracted tariffed or month-to-month service, check
the corresponding box.
a. Tariffed services. A tariffed service is a telecommunications service that you purchase at prices
(rates) regulated by your state regulatory commission and/or the FCC, for which you do not have
a signed, written contract.
b. Month-to-month services. Certain services are commonly offered on the basis of a month-tomonth arrangement where there may be no contract between the customer and the service
provider, e.g. Internet access. These arrangements are different from tariffed services, which
may also be offered month-to-month but at regulated prices.
Item 15b – If you are receiving services under a contract, enter the contract number in Item 15b.
a. If this is a contracted service and the contract does not have a contract number but has some
other reference number, you should note that number in Item 15b.
b. If you are buying off of a preferred master contract or a master contract signed by a state,
regional or local procurement agency on behalf of eligible schools and libraries, you may use
either the master contract number or the number of your own purchase agreement executed
pursuant to that master contract. Whichever number you use, be certain that you use the
corresponding dates in Item 18 and Item 19c.
Item 15c – Check this box if this funding request is covered under a master contract – a contract
negotiated by a third party, the terms and conditions of which are then made available to an eligible
entity that purchases directly from the service provider.
Item 15d – Check this box if this funding request is a continuation of an FRN from a previous
funding year based on a multi-year contract. If so, enter that FRN in the space provided.
Starting in Funding Year 2016, checking Item 15d will allow applicants seeking funding for a multiyear contract to fill out a streamlined application. This simplified application process will be
available to applicants with multi-year contracts that are five years or less in duration that have: (1)
submitted in Funding Year 2015 or later a complete FCC Form 471 for the first funding year they are
seeking E-rate support for services under that contract; and (2) changes in the requested services or to
the terms and conditions under which those services are provided are within the scope of the
establishing FCC Form 470 and the applicable contract.
Item 15e – Check this box if there is a restriction that prevents information provided in the Item 21
from becoming public. Applicants must certify that there is a state law or statute, local rule, court
order, or contract executed before the effective date of the E-rate Modernization Order (FCC 14-99)
barring publication of the information provided in the Item 21. Select the type of restriction and
provide a precise cite to the law, statute, or court order or, in the case of a contract, provide the
contract number, paragraph number that contains the restrictive terms and the date the contract was
executed. Note that contracts and other agreements executed after September 18, 2014 may not
prohibit pricing disclosure, and any such restrictions will have no effect. Also, you must retain the
documents necessary to demonstrate the restriction.
Item 16 – Provide the account number that your service provider has established with you for billing
purposes. This information will help your service provider provide you with discounted bills for service.
In the case of telephone services, this is most often the billed telephone number associated with the
service. If there are multiple billed telephone numbers or multiple Billing Account Numbers,
provide one main number in Item 16a, check the box in Item 16b, and include all of the numbers in
the space provided. If this service is already established (for example, a service provided under a
qualified existing contract, or tariffed services for which you have selected the same service provider
Page 15
FCC Form 471 Instructions – October 2014
OMB 3060-0806
who already provides you with service), you should be able to find your account number on past bills, or
you can request your account number from the service provider. If you have not yet established an
account number, your service provider may have a “pre-account” identifier for you to use.
Item 17 – If you entered an FCC Form 470 number in Item 12a, the system will list the Allowable
Vendor Selection/Contract Date for this service. The Allowable Vendor Selection/Contract Date is the
earliest date after posting the FCC Form 470 that you are permitted to select your service provider and to
sign a contract for newly contracted services, as applicable. This Allowable Vendor Selection/Contract
Date for the FCC Form 470 cited in Item 12a above is identified in your Receipt Notification Letter and –
in the FCC Form 470 posted – on the USAC website. Note, however, that if you issued a Request for
Proposal (RFP) after you posted your FCC Form 470, your Allowable Vendor Selection/Contract Date
may be later than the date identified on your FCC Form 470 Receipt Notification Letter. If you selected
Item 12 b or 12c, this item will not appear on your online form.
Item 18 – For contracted services, enter the date that your contract for this service was executed. This
item will not appear if you indicated in Item 15a that you are purchasing tariffed or month-to-month
services.
If this funding request is covered under a state master contract but the state did not file an FCC Form
470, enter the date that you chose the state master contract as the most cost-effective offering pursuant to
your posted FCC Form 470, rather than the date that the state master contract was actually signed.
•
•
•
•
Item 19a – For all services, provide the date when services will start in the funding year for which
you are applying. With the exception Category Two non-recurring services (see below), discounts
are not provided for services delivered before the beginning of the Funding Year, which starts on
July 1. Thus, if this service has already started by the time you file this FCC Form 471, you will use
July 1 of the funding year as your Service Start Date.
Starting in Funding Year 2015, applicants seeking Category Two non-recurring services are
permitted to seek support for services purchased on or after April 1, three months prior to the start of
funding year on July 1.
Item 19b – If you indicated in Item 15a that you are purchasing tariffed or month-to-month services,
enter the date that services will end in the funding year for which you are applying. This item will
not appear if you are filing for contracted services.
Item 19c – For contracted services, enter the date the contract expires. This item will not appear if
you indicated in Item 15a that you are purchasing tariffed or month-to-month services.
Item 19d – For contracted services, indicate whether the contract for this FRN includes a clause that
permits the parties to extend or renew the agreement at the end of the initial contract period. If so,
check the box and indicate the number of possible extensions remaining and the total number of
years the contract can be extended if all extensions are exercised. This item will not appear if you
indicated in Item 15a that you are purchasing tariffed or month-to-month services.
Item 20 – Calculations:
Based on the information provided in the Item 21 for this funding request, the system will automatically
sum the monthly recurring eligible, monthly recurring ineligible, one-time eligible, and one-time
ineligible total costs. Using the information provided in Item 19, the system will also calculate the
months of service you a requesting. Using the information provided in Block 4, the system will them
apply the relevant discount rate (Category One or Category Two) to derive the total funding commitment
request.
Page 16
FCC Form 471 Instructions – October 2014
OMB 3060-0806
NOTE: If you checked Voice Services as the service type in Item 11, your discount will be automatically
reduced each year by 20 percentage points. For example, if the discount you calculated for the entities
receiving Voice Services is 90 percent for Funding Year 2015, your discount for Voice Services will be
70 percent for Funding Year 2015.
Item 21 – Each Funding Request must include a description of the products and services for which
discounts are being sought. Applicants complete one or more line-item entries for all products or
services in the funding request for the service type identified in Item 11.
• Complete Item 21a for Telecommunications (including Voice) and Internet Access
• Complete Item 21b for Internal Connections
• Complete Item 21c for Managed Internal Broadband Services
• Complete Item 21d for Basic Maintenance of Internal Connections
In all cases, you will be asked for the following information. Additional guidance for completing Items
21a, 21b, 21c, and 21d is provided below.
• Provide a narrative overview or description of the service(s) included in the funding request.
• For each product or service sought, use a separate line to describe the products or services. If
you have the several of the same product or service but they are delivered at different speeds, use
a separate line for each. The system will automatically assign an FRN line item number to track
the specific request.
• Recipients of Service:
- For Category One requests, the system will display the list of entities you entered in Block 4
and will allow you to select all or some of the entities to indicate who is receiving that
service. If the service is a Last Mile connection, the system will also prompt you to specify,
on a per entity basis, the specific quantity and types of circuits that form that last mile
connection.
- For Category Two requests, the system will display the list of entities you entered in Block 4
and will allow you to select all or some of the entities to indicate who is receiving that
service. In addition, you will need to allocate the cost of the service among the recipients of
service. In order to assist you, the system will offer to split the cost equally based on either
the number of entities served, or proportionately based on the student population, or you can
enter your own cost allocation. Remember that all cost allocations must be based on tangible
criteria and reach a realistic result.
• Cost of the product or service: After describing the services sought, you will be asked to list the
costs associated with the specific product or service. Provide the following information:
- Monthly Recurring Eligible Cost: Enter your total monthly cost for this service. If the cost
of service fluctuates from month to month, you may use the average of past bills to estimate
the monthly cost.
- Monthly Recurring Ineligible Cost: Enter the total cost associated with ANY ineligible
services, entities, or uses included in your monthly charges. The following represent some
common ways in which eligible and ineligible costs are bundled together, and how you can
go about deducting the ineligible costs.
• Eligible services bundled with ineligible services: While you may contract with the
same service provider for both eligible and ineligible services, your contract must clearly
break out costs for eligible services from those for ineligible services. If the eligible and
ineligible services were purchased together at a special “bundled” price, a proportionate
cost allocation is required between the eligible and ineligible components. You will use
this reduced price when requesting universal service discounts on the eligible service.
For example, if a provider offers to sell a school an eligible service for $10.00 and an
Page 17
FCC Form 471 Instructions – October 2014
OMB 3060-0806
ineligible service for $20.00, but also offers them as a bundle for $24.00, this would
indicate that the provider is offering a $6.00, or 20%, price reduction. Therefore, the
school could treat $10.00 * 80% = $8.00 as eligible for universal service support.
• Services shared by eligible and ineligible entities: When you share a service with an
ineligible entity, the provider may receive reimbursement only for that portion of the
service that eligible entities are receiving. To help auditors confirm that this rule is
being observed, you must keep and retain careful records of how you have allocated the
costs of shared services and facilities among eligible and ineligible entities. You are
required to maintain these records consistent with any measures that may be established
by the FCC, the USAC, or state commissions.
• Bundled services from an Internet service provider: You may receive discounts on
access to the Internet but not on separate charges for content (such as access to a library
of videos supplied by the service provider) or other information services. In addition, if
you choose a package including content and conduit, you may only receive a discount on
the conduit portion of the package. The only exception is when the bundled package
includes minimal content and provides a more cost-effective means of securing access to
the Internet than other non-content-providing alternatives. Thus, if a service provider
bundles Internet access with a package of content that is available to all customers free
of charge, the entire price of that bundle will be eligible for support if that package is the
most cost-effective solution. However, if the service provider a) does not offer an
access-only service, and b) offers Internet users access to its proprietary content for a
price, then you must treat the difference between the content-only price and the price the
service provider charges for its bundled access as the price of non-content Internet
access.
- One-time Eligible Cost: Enter your one-time or non-recurring costs for the product or
service. If you expect to pay a non-recurring charge in multiple installments over the funding
year, you should either amortize this charge as monthly amount or include the full amount of
this charge as a one-time charge. DO NOT include this amount under both recurring and
non-recurring charges. If you amortize this charge as a monthly amount, you will not be
eligible for discounts on any non-recurring services in this funding request provided
after June 30 of the funding year.
- One-time Ineligible Cost: Enter the total cost associated with ANY ineligible services,
entities, or uses included in your one-time charges. See above for common ways in which
eligible and ineligible costs are bundled together, and how you can go about deducting the
ineligible costs.
- Pre-discount Extended Eligible Line Item Cost – The system will automatically calculate
the total pre-discount amount for this FRN line, based on the information that you have
provided.
Note about applicant Category Two Budgets: As you enter funding requests on this application,
the system will track the total pre-discount dollars on a per school or library basis and compare that
to the Category Two Applicant Budgets displayed in Block 4. If the pre-discount costs featured on
the funding requests on this form exceed that amount, you will be notified by the system that some
funds may be denied because you appear to have exceeded your Category Two budget. Although
applicants can request more than their Category Two Applicant budget, commitments will be capped
based on the school or library’s budgeted pre-discount amount. Applicants should also carefully
review any other applications they filed, or by other organizations on their behalf, such as consortia,
to determine if an individual school or library has exceeded its Category Two budget.
Page 18
FCC Form 471 Instructions – October 2014
OMB 3060-0806
Specific instructions for Items 21a, 21b, 21c, and 21d
Item 21a – Telecommunications (including Voice) and Internet Access
For each unique service, provide the information below in addition to the narrative description. If you
have several services that are the same type of service but are delivered at different speeds, use a separate
line for each.
• Type of service (from the types of services on the Eligible Services List for the appropriate
funding year) – e.g., Digital Transmission Service, Telephone Service, Internet Access, etc.
• Type of connection (from the types of connections on the Eligible Services List for the
appropriate funding year) – e.g., fiber, T-1, T-3.
• Purpose (transport, Internet, both transport and Internet, voice). Note that if you cannot combine
voice services with any other type of service in an FRN. Therefore, if you select Voice in this
column, and you are also seeking support for other non-voice Category One services, you must
complete a separate funding request for that request.
• Quantity or number of lines.
• Bandwidth upload speed: Enter the upload speed in megabits per second (Mbps or Gbps). If the
line has an industry-standard definition for speed, it will be populated for you by the system.
• Bandwidth download speed: If different than bandwidth upload speed, enter the download speed
in megabits per second (Mbps or Gbps).
• Maximum speed if you have burstable bandwidth: If your service contains an option to increase
the bandwidth when requested, indicate Yes and enter the burstable speed in megabits per second
(Mbps or Gbps).
• Note if basic firewall protection is included in the cost of the service.
• From the list you entered in Block 4, select the schools, libraries and NIFs that are receiving this
service.
• Last Mile Connection: Indicate whether the broadband or Internet Access connection is a lastmile connection that connects individual schools and libraries to a central aggregation point. If
so, you will need to provide specific allocation of the lines on a per-school or per-library basis.
• WAN Connection: Indicate whether the Internet Access connection is part of a wide area
network (WAN) that serves the entire district.
• Enter the costs for the service, as described above.
• The system will calculate the extended total cost for each line item.
Item 21b – Internal Connections
Internal Connections: For each unique product or service, provide the information below in addition to
the narrative description.
• Type of Internal Connections – e.g., wireless data distribution, cabling or connectors.
• Type of Product – e.g., router, firewall, cabling, coax.
• Quantity and unit.
• Make.
• Model.
• Indicate if this is being procured under a lease or non-purchase arrangement.
• Enter the costs for the service, as described above.
• From the list you entered in Block 4, select the schools, libraries and NIFs that are receiving this
service. As indicated above, you will need to allocate the cost of the service among the
recipients of service. The system can help you with straight line cost allocations or you can use
another method for allocating the costs, as long as the cost-allocation methodology is based on
Page 19
FCC Form 471 Instructions – October 2014
OMB 3060-0806
tangible criteria and reaches a realistic result.
Item 21c –Managed Internal Broadband Services
Managed Internal Broadband Services: For each unique service and/or product, provide the information
below in addition to the narrative description.
• Type of managed service agreement – Select the service arrangement that most closely matches
your contract: (1) managed and leased from a third party service provider; (2) managed by third
party service provider; (3) purchased from them or other vendors; or (4) managed services
contract of already installed equipment.
• Enter the costs for the service, as described above.
• From the list you entered in Block 4, select the schools, libraries and NIFs that are receiving this
service. As indicated above, you will need to allocate the cost of the service among the
recipients of service, keeping in mind that NIFs are not eligible for their own Category Two
budget. However, you can use some of the budget from the schools that are sharing the
equipment located in that central site to purchase equipment shared by the schools and housed at
the NIF. You will need to cost-allocate the equipment among all of the schools that are sharing
that piece of equipment. The system can help you with straight line cost allocations or you can
use another method for allocating the costs, as long as the cost-allocation methodology is based
on tangible criteria and reaches a realistic result.
Item 21d – Basic Maintenance of Internal Connections
For each unique service, provide the information below in addition to the narrative description.
• Type of internal connections being maintained, such as Data Distribution Equipment.
• Type of product being maintained, such as Router or WAP
• Quantity and unit
• Make of covered equipment
• Model of covered equipment
• Cost allocation percentage (if either the product being maintained not 100 percent eligible or the
cost of the maintenance itself is not fully eligible).
• Enter the costs for the service, as described above.
• From the list you entered in Block 4, select the schools, libraries and NIFs that are receiving this
service. As indicated above, you will need to allocate the cost of the service among the
recipients of service. The system can help you with straight line cost allocations or you can use
another method for allocating the costs, as long as the cost-allocation methodology is based on
tangible criteria and reaches a realistic result.
D.
Block 6: Certifications and Signature
Block 6 requires program participants to certify certain information. This information is required to
ensure that only eligible entities receive support under the universal service discount mechanism.
• When you have completed the online filing of Blocks 1-5, please print your application to retain a
copy for your records.
• You must also submit the Block 6 certification.
• If you have a PIN and wish to submit your Block 6 certification online, follow the directions
online. When you submit your certification online, you will receive a confirmation. If you use
the online certification, do not mail any part of your FCC Form 471 to USAC.
• If you wish to submit the completed and signed Block 6 certification on paper, print Block 6
using your browser. When you print Block 6 using the browser, the form will automatically
Page 20
FCC Form 471 Instructions – October 2014
OMB 3060-0806
include your FCC Form 471 Application Number, Applicant Name, and Applicant Address. Item
36 requires the signature of the authorized person who certifies to the accuracy of the
information on the form. Also, you must complete Items 22-40e. Mail the signed Block 6 to:
USAC-Form 471, P. O. Box 7026, Lawrence, KS 66044-7026. For express delivery services
or U.S. Postal Service Return Receipt Requested, send to USAC-Forms 471, ATTN: USAC
Form 471, 3833 Greenway Drive, Lawrence, KS 66046. If the Block 6 certification is
submitted on paper, you are advised to keep proof of the date of mailing.
The FCC Form 471 cannot be submitted by mail. With the exception of the Block 6 certification, the
FCC Form 471 must be completed and submitted online.
Item 22 – Certify that the entities represented are eligible schools and/or libraries.
Item 23 – Check this box to certify that you can demonstrate that you have secured access to all of the
resources necessary to make effective use of the products and services for which they receive discounts.
As part of our review of your Item 23 certification, USAC may request additional documentation to
support your certification. The certification in Item 31 below states that you will retain for at least 10
years (or whatever retention period is required by the rules in effect at the time of certification), after the
last day of service delivered any and all worksheets and other records that you rely upon to fill out your
FCC Form 471. For Item 23, these worksheets and records include:
• Paying your share of E-rate eligible costs. You may be asked to provide documentation of
your ability to pay the non-discount portion of the products and services for which you have
applied for discounts. You are required to already have the funds identified in your budget to
pay for these costs. If your budget is not yet final, we may request additional documentation to
substantiate your certification.
• Paying for ineligible costs. You may be asked to provide more detailed estimates of hardware,
software, professional development, retrofitting (construction and electrical work necessary to
prepare a building for technology), maintenance investments and other resources that are
necessary to make effective use of the E-rate discounts you have requested. If these resources
will be purchased under your budget, you must already have the funds identified in your budget
to pay for them. However, these resources may also be ones that you already have or own, such
as computers purchased or donated in a prior year.
Item 23a – Add your entries from Items 20I, Total funding year pre-discount amount, on all Block 5
Discount Funding Requests and enter the total here. The online system will calculate this figure for you.
Item 23b – Add your entries from Items 20K, Funding Commitment Request, on all Block 5 Discount
Funding Requests and enter the total here. The online system will calculate this figure for you.
Item 23c – Subtract Item 23b from Item 23a and enter the result here. This is the total non-discount
share for the funding requests on this FCC Form 471. Remember that applicants are required to pay this
non-discount portion of the cost of E-rate eligible products and services to their service providers. The
online system will calculate this figure for you.
Item 23d – Enter the total amount in your budget that has been allocated for resources not eligible for Erate support. These are the resources that are necessary for you to support and improve education and
library services and to make effective use of the eligible services you have requested in all Block 5
funding requests across all FCC Forms 471 you will submit for this funding year. These resources may
include, but are not limited to:
• Hardware, such as computers, printers, fax machines, video equipment, scanners, CD-ROM
drives, and servers;
Page 21
FCC Form 471 Instructions – October 2014
OMB 3060-0806
•
Professional development, such as ongoing technology-related training for technical staff,
teachers and/or librarians;
• Software, such as end-user applications;
• Maintenance, such as systems maintenance and operations costs for ineligible hardware and
software and salaries of technical staff;
• Retrofitting, such as electrical wiring, asbestos removal, building modifications, renovations, and
repairs.
If you file multiple FCC Forms 471 for this funding year, you must calculate your total budgeted amount
allocated for these resources and enter that total on Item 23d of each FCC Form 471. Consortia must add
the budgeted amounts for all of their member entities and enter that total on this line.
Item 23e – Add your entries for Item 23c and Item 23d and enter the total here. This is the amount
necessary to pay the non-discount share of the services requested on this FCC Form 471 AND to make
effective use of the discounts requested on all your applications for this funding year. This amount will
not include amounts necessary to pay the non-discount share of requests on other FCC Forms 471.
Item 23f – Check this box if your service provider has provided direct financial assistance to you for any
of the funds in Item 23c or Item 23d. Also, check this box if your service provider assisted you in
locating funding for any of the funds in Item 23c or Item 23d. Service providers may assist applicants in
locating grants and donations consistent with program rules and the Obligation to Pay Non-Discount
Portion notice on the USAC website. Service providers may provide assistance to applicants for
ineligible products and services consistent with program rules and the Free Services Advisory as
explained on the website.
Items 24-26 –Check the appropriate box(es) to certify that you are citing an FCC Form 470 that formed
the basis of a competitive bidding process that complied with all program rules and/or that the services
you have ordered are exempt from the requirement to post an FCC Form 470.
Item 27 – Check this box to certify that the entity responsible for selecting the service provider has
reviewed all applicable competitive bidding requirements and complied with them.
Item 28 – Check this box to certify that services you order pursuant to the universal service discount
mechanism will be used primarily for educational purposes and will not be sold, resold, or transferred for
gain except as permitted under program rules. Additionally, you certify that the entities listed on this
application have not received anything of value in connection with this request for services.
Item 29 – Check this box to certify that you and the entity(ies) you represent have complied with all
program rules, including recordkeeping requirements, and that you acknowledge failure to do so may
result in denial of discount funding and/or cancellation of funding commitments. You also certify that
there are signed contracts or legally binding agreements covering all of the services listed on this FCC
Form 471 except for those services provided under non-contracted tariffed or month-to-month
arrangements. You acknowledge that failure to comply with program rules could result in civil or
criminal prosecution by the appropriate law enforcement authorities.
Item 30 – Check this box to certify that you understand that the discount level used for shared services is
conditional, for future years, upon ensuring that the most disadvantaged schools and libraries that are
treated as sharing in the shared services receive an appropriate share of benefits from those services.
Page 22
FCC Form 471 Instructions – October 2014
OMB 3060-0806
Item 31 – Check this box to certify that required documents will be retained for a period of at least 10
years (or whatever retention period is required by the rules in effect at the time of this certification), after
the last day of service delivered and to acknowledge that you may be audited pursuant to participation in
the schools and libraries program.
Item 32 – Check this box to certify that you are the person authorized to order telecommunications and
other supported services on behalf of the eligible entity(ies) and are authorized to submit and certify to
the accuracy of this form.
Item 33 – Check this box to acknowledge that FCC rules provide that persons who have been convicted
of criminal violations or held civilly liable for certain acts arising from their participation in the schools
and libraries support mechanism are subject to suspension and debarment from the program. You agree
to institute reasonable measures to be informed, and will notify USAC should you be informed or
become aware that you or any of the entities named on this FCC Form 471, or any person associated in
any way with your entity and/or the entities named on this FCC Form 471, is convicted of a criminal
violation or held civilly liable for acts arising from their participation in the schools and libraries support
mechanism.
Item 34 – Check this box to certify that if any of the Funding Request Numbers on this FCC Form 471
contain requests for discounts for products or services that contain both eligible and ineligible
components, that you have allocated the cost of eligible and ineligible components as required by the
Commission's rules.
Item 35 – Check this box to certify that the non-discount portion of the costs for eligible services will not
be paid by the service provider, and that the pre-discount costs of eligible services featured on this FCC
Form 471 are net of any rebates or discounts offered by the service provider.
Item 36 – Requires the signature of the authorized person.
Item 37 – Provide the date of signature of the FCC Form 471. Note that for applications requesting new
services based on the filing of an FCC Form 470, this date CANNOT be earlier than any Allowable
Vendor Selection/Contract Date in Item 17 of any Block 5 submitted with this application.
Item 38 – Print the name of the authorized person whose signature is provided in Item 36.
Item 39 – Provide the title or position of the authorized person whose signature is provided in Item 36.
If the consultant in Item 6g is the Authorized Person, check the appropriate box.
Item 40a-40d – Provide the mailing address, the telephone number, the fax number and the e-mail
address of the authorized person whose signature is provided in Item 36.
Item 40e – Provide the name of the authorized person’s employer. If a consultant is acting as the
authorized person, provide the name of the company that employs the consultant, not the name of the
applicant organization.
Page 23
FCC Form 471 Instructions – October 2014
| File Type | application/pdf |
| Author | Catriona Ayer |
| File Modified | 2015-04-30 |
| File Created | 2014-11-19 |