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pdfFCC Form 525
High Cost Support Mechanism
Competitive Carrier Line Count Report
FCC Form 525
OMB Control No. 3060-0986
July 2018
COMPETITIVE CARRIERS HIGH COST DATA SUBMISSION
(1) Quarterly Submission Date:
Do Not Write in this Area:
For Administrator's Use Only
(2) USAC Service Provider Identification Number (SPIN):
(3) Company Study Area Code: (First time filers leave blank and a Study Area Code will be assigned)
(4) Study Area Name:
(5) Company Legal Name:
(6) Filer 499 ID:
Check Box if this is a new address/contact from a previous data submission:
(7) Mailing Address:
(8) Contact Name:
(9) Title:
(10) Telephone Number:
(11) E-mail Address:
(12) Mechanism for which you are requesting support:
(13) Lines Reported as of:
(14) Type of Filing
Revision
Original
(15) Worksheet to Complete
High Cost Loop Support (HCL)
Complete HCL and LSS
Local Switching Support (LSS)
Complete HCL and LSS
Interstate Common Line Support (ICLS)
Complete ICLS Worksheet
High Cost Model Support (HCM)
Complete HCM Worksheet
Interstate Access Support (IAS)
Complete IAS Worksheet
Competitive Carrier Information
Page 1
FCC Form 525
OMB Control No. 3060-0986
July 2018
FCC Form 525
High Cost Support Mechanism
Competitive Carrier Line Count Report
HIGH COST LOOP (HCL) AND LOCAL SWITCHING SUPPORT (LSS) LINE COUNT WORKSHEET
(2) USAC Service Provider Identification Number (SPIN):
Do Not Write in this Area:
For Administrator's Use Only
0
(3) Company Study Area Code:
0
(4) Study Area Name:
0
(13) Lines Reported as of:
(14) Type of Filing:
Line Count Data for Path 1, 2 & 3 Carriers
Where carrier reports both UNEs and facilities based lines in the same SAC or disaggregation zone, carrier shall list UNEs in a separate row.
Complete one row for each disaggregation zone.
(16) Incumbent Carrier Name
(17) Incumbent
Carrier SAC
(18) ETC
Designation
(19) Path
Designation
(20) Disaggregation Zone
Name
(21) Wire Center CLLI Code
(22) Total Number of
Lines in Service
(23) Were any lines provided through UNEs?
If yes, please fill out the UNE Agreement
Information.
Use an additional sheet if necessary.
HCL & LSS Line Count Worksheet
Page 2
FCC Form 525
OMB Control No. 3060-0986
July 2018
FCC Form 525
High Cost Support Mechanism
Competitive Carrier Line Count Report
INTERSTATE COMMON LINE SUPPORT (ICLS) LINE COUNT WORKSHEET
(2) USAC Service Provider Identification Number (SPIN):
Do Not Write in this Area:
For Administrator's Use Only
0
(3) Company Study Area Code:
0
(4) Study Area Name:
0
(13) Lines Reported as of:
(14) Type of Filing:
Line Count Data for Path 1, 2 & 3 Carriers
Complete one row for each disaggregation zone.
(24) Incumbent Carrier Name
(25) Incumbent
Carrier SAC
(26) ETC
Designation
(27) Path Designation
(28) Disaggregation
Zone Name
(29) Wire Center CLLI
Code
(30) Residence & Single
Line Business
(31) Multi-line
Business
(32) Total Number of
Lines in Service
Use an additional sheet if necessary.
ICLS Line Count Worksheet
Page 3
FCC Form 525
High Cost Support Mechanism
Competitive Carrier Line Count Report
FCC Form 525
OMB Control No. 3060-0986
July 2018
HIGH COST MODEL (HCM) LINE COUNT WORKSHEET
(2) USAC Service Provider Identification Number (SPIN
Do Not Write in this Area:
For Administrator's Use Only
0
(3) Company Study Area Code:
0
(4) Study Area Name:
0
(13) Lines Reported as of:
(14) Type of Filing:
Complete one row for each Wire Center.
(33) Incumbent Carrier Name
(34)
Incumbent
Carrier SAC
(35) ETC
Designation
(36) Wire Center CLLI Code
(37) Wire Center Name
(38) Total Lines
Use an additional sheet if necessary.
HCM Line Count Worksheet
Page 4
FCC Form 525
High Cost Support Mechanism
Competitive Carrier Line Count Report
FCC Form 525
OMB Control No. 3060-0986
July 2018
INTERSTATE ACCESS SUPPORT (IAS) LINE COUNT WORKSHEET
(2) USAC Service Provider Identification Number (SPIN
(3) Company Study Area Code:
0
(4) Study Area Name:
0
(13) Lines Reported as of:
#REF!
(14) Type of Filing:
#REF!
Complete one row for each Incumbent Carrier Area Served.
(39) Incumbent Carrier Name
Do Not Write in this Area:
For Administrator's Use Only
0
Zone 1
(42) Residence &
(40) Incumbent
(41) ETC
Single Line
(43) Multi-line
Carrier SAC
Designation
Business
Business
Zone 2
(44) Residence &
Single Line
(45) Multi-line
Business
Business
Number of Lines
Zone 3
(46) Residence &
Single Line
(47) Multi-line
Business
Business
Zone 4
(48) Residence &
Single Line
(49) Multi-line
Business
Business
(50) Total Lines
Use an additional sheet if necessary.
IAS Line Count Worksheet
Page 5
FCC Form 525
OMB Control No. 3060-0986
July 2018
FCC Form 525
High Cost Support Mechanism
Competitive Carrier Line Count Report
UNBUNDLED NETWORK ELEMENTS REPORTING
(2) USAC Service Provider Identification Number (SPIN):
Do Not Write in this Area:
For Administrator's Use Only
0
(3) Company Study Area Code:
0
(4) Study Area Name:
0
Complete one worksheet for each study area of a Path 1 rural incumbent carrier in which the competitive carrier is reporting lines and uses unbundled network elements ("UNEs") to serve the reported lines. The competitive carrier must separately identify the number of UNE loops; UNE price per loop; any port and vertical services costs
included in the UNE loop price; number of loops receiving UNE switching service, the UNE switching price per minute and number of switching minutes.
(51) Incumbent Carrier Name:
(52) Incumbent Carrier Study Area Code:
Please provide the following information for Path 1 Rural Incumbent Carrier Study Areas:
(53) UNE Zone
Loops w/o Port Cost
(54) No. of Loops
(55) Price per loop
Loops w/ Ports
(56) No. of ports
(57) Price/port
Vertical Services
Switching
(58) No. of loops w/ Vertical (59) Price for vertical services
(60) No. of loops with switching
Services
on each loop
(61) No. of switching minutes
(62) Price/minute
Zone 1
Zone 2
Zone 3
Zone 4
Zone 5
Complete one worksheet for each study area of a Path 2 or Path 3 rural incumbent carrier in which the competitive carrier is reporting lines and uses unbundled network elements ("UNEs") to serve the reported lines. For each incumbent study area, list the name of each disaggregation zone
. If the disaggregation zone includes more than
one UNE zone, please report the lines in each UNE zone per disaggregation zone on a separate row. The competitive carrier must separately identify the number of UNE loops; UNE price per loop; any port and vertical services costs included in the UNE loop price; number of loops receiving UNE switching service, the UNE switching price
per minute and number of switching minutes.
Please provide the following information for Path 2 and Path 3 rural incumbent carrier study areas:
(63) UNE Zone Name
(64) Disaggregation Zone Name
(65) UNE type
(66) Quantity
(67) Price
(68) Minutes
Loops without port costs
Ports
No. of loops w/ Vertical Services
No. of loops w/ switching
Loops without port costs
Ports
No. of loops w/ Vertical Services
No. of loops w/ switching
Loops without port costs
Ports
No. of loops w/ Vertical Services
No. of loops w/ switching
Loops without port costs
Ports
No. of loops w/ Vertical Services
No. of loops w/ switching
Loops without port costs
Ports
No. of loops w/ Vertical Services
No. of loops w/ switching
UNE Agreement Information
Page 6
FCC Form 525
High Cost Mechanism
Competitive Carrier Line Count Report
FCC Form 525
OMB Control No. 3060-0986
July 2018
TO BE COMPLETED BY THE REPORTING CARRIER, IF THE REPORTING CARRIER IS FILING FCC FORM 525 ON ITS OWN BEHALF:
Certification of Officer or Employee as to the Accuracy of the Data Reported in FCC Form 525, Line Count Report for Competitive Carriers, on
Behalf of Reporting Carrier
I certify that I am an officer or employee of the reporting carrier; my responsibilities include ensuring the accuracy of the actual line count data reported on
FCC Form 525; and, to the best of my knowledge, the information reported on this form is accurate.
Name of Reporting Carrier:
0
Service Provider Identification Number:
0
Signature of authorized officer or employee:
Date:
Printed name of authorized officer or employee:
Title or position of authorized officer or employee:
Telephone number of authorized officer or employee: (
Study Area Code of Reporting CETC
0
)
-
ext.
Filing Due Date for this form
(mm/dd/yyyy)
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or
imprisonment under Title 18 of the United States Code, 18 U.S.C. § 1001.
Certification-Reporting Carrier
Page 7
FCC Form 525
OMB Control No. 3060-0986
July 2018
FCC Form 525
High Cost Support Mechanism
Competitive Carrier Line Count Report
TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING FCC FORM 525 ON THE CARRIER'S BEHALF:
Certification of Officer or Employee to Authorize an Agent to File FCC Form 525, Line Count Report for Competitive Carriers, on Behalf o
Reporting Carrier
I certify that (Name of Agent)_______________________________________________________ is authorized to submit the information reported on FCC
Form 525 on behalf of the reporting carrier. I also certify that I am an officer or employee of the reporting carrier; my responsibilities include ensuring
the accuracy of the actual line count data provided to the authorized agent; and, to the best of my knowledge, the actual line count data provided to the
authorized agent is accurate.
Name of Authorized Agent:
Name of Reporting Carrier:
0
Service Provider Identification Number:
0
Signature of authorized officer or employee:
Date:
Printed name of authorized officer or employee:
Title or position of authorized officer or employee:
Telephone number of authorized officer or employee: (
Study Area Code of Reporting CETC
)
0
ext.
Filing Due Date for this form
(mm/dd/yyyy)
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or
imprisonment under Title 18 of the United States Code, 18 U.S.C. § 1001.
TO BE COMPLETED BY THE AUTHORIZED AGENT:
Certification of Agent Authorized to File FCC Form 525, Line Count Report for Competitive Carriers, on Behalf of Reporting Carrier
I, as agent for the reporting carrier, certify that I am authorized to submit the information reported on FCC Form 525 on behalf of the reporting carrier; I have
provided the line count data reported herein based on actual line count data provided by the reporting carrier; and, to the best of my knowledge, the
information reported herein is accurate. I also certify that I will provide copies of the line count filing to the reporting carrier within 15 days.
Name of Reporting Carrier:
0
Name of Authorized Agent:
Signature of authorized agent or employee of agent:
Date
Printed name of authorized agent or employee of agent:
Title or position of authorized agent or employee of agent:
Telephone number of authorized agent: (
Study Area Code of Reporting CETC
)
0
ext.
Filing Due Date for this form
(mm/dd/yyyy)
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or
imprisonment under Title 18 of the United States Code, 18 U.S.C. § 1001.
Certification-Agent
Page 8
FCC Form 525
High Cost Support Mechanism
Competitive Carrier Line Count Form
FCC Form 525
OMB Control No. 3060-0986
July 2018
NOTICE: Sections 54.307(b) and 54.802(a) of the Federal Communications Commission's rules requires all competitive eligible telecommunications carriers to
provide line count information to USAC, the universal service Administrator, in order to be eligible to receive support. Pursuant to Sections 54.307(c) and
54.802(a), this information must be submitted by support mechanism on a quarterly basis in accordance with the incumbent carrier's line count reporting schedule.
This collection of information stems from the Commission's authority under Section 254 of the Communications Act of 1934, as amended, 47 U.S.C. §254. The
data in the form will be used to calculate the amount of support, if any, that each reporting carrier is eligible to receive from the High Cost support mechanisms.
We have estimated that each response to this collection of information will take, on average, 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 (3060-0986). We also will accept your comments via the Internet if you send them to [email protected].
Please DO NOT SEND COMPLETED DATA COLLECTION FORMS TO THIS ADDRESS.
Remember -- 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 3060-0986.
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 to determine High Cost support amounts for competitive eligible telecommunications carriers. If we believe there may be a violation or potential
violation of a statute or 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, court, or other adjudicative body when (a) the Commission; (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.
If you do not provide the information we request on this form, you are not eligible to receive support under the High Cost support mechanisms, 47.C.F.R. §§
54.307 and 54.802.
The foregoing Notice is required by the Paperwork Reduction Act of 1995, P.L. No. 104-13, 44 U.S.C. § 3501, et seq.
Notice
Page 9
| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |