Appendix B DA 20-1529 Lifeline Provider Data Collection Filing Instructions B-1 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 Contents Lifeline Data Collection Overview ........................................................................................................... 3 Who Must Submit Data ........................................................................................................................... 3 What Must be Submitted ........................................................................................................................ 3 1. Subscriber Information:................................................................................................................... 4 2. Mobile Virtual Network Operator (MVNO) Providers: .................................................................... 7 3. Facilities-Based Providers: ............................................................................................................. 11 4. Overhead Costs ............................................................................................................................. 13 Confidentiality ...................................................................................................................................... 15 Certification & Submission .................................................................................................................... 15 B-2 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 Lifeline Data Collection Overview In an Order released on December 23, 2020, the Wireline Competition Bureau (Bureau) established a one-time data collection that seeks discrete cost and usage data from a group of Lifeline service providers necessary to inform the policy choices before the Commission regarding the mobile broadband minimum service standards and voice support phase-down, and to aid the development of the 2021 State of the Lifeline Marketplace Report. Responses to this collection are due 60 days after receipt of the questionnaire and instructions by the respondent service provider. Who Must Submit Data Pursuant to the Bureau s Order of December 23, 2020, the following nine (9) Lifeline service providers are required to fully and accurately complete the Lifeline Data Collection questionnaire and submit it to the Bureau in compliance the Bureau s Order and with the filing instructions provided below: 1. Deutsche Telekom AG 2. América Móvil 3. Quadrant Holdings Group LLC 4. TSC Acquisition Corporation 5. Telrite Corporation 6. Amerimex Communications Corporation 7. i-wireless, LLC 8. Global Connection Inc. of America 9. Assist Wireless, LLC Throughout these instructions, the above Lifeline service providers may be referred to as  you or  respondent. Each provider should respond as a single entity, regardless of the number of separately incorporated operating companies or individual employees. What Must be Submitted Respondents must fully and completely respond to each question to the extent it is relevant to their voice and broadband service operations in the United States. A valid entry must be submitted on the template spreadsheet for each component of the required information. These instructions set forth the requirements for a valid entry. These instructions instruct you to mark  N/A or leave an entry blank in certain circumstances. You must explain any other use of  N/A or  blank. You must also provide an explanation for any other entry that does not provide all or part of the requested information. If you have any questions about completing this form, please contact the Bureau at LifelineCollection@fcc.gov before submitting your responses. If the spreadsheet is not completed properly, the form may be rejected and/or returned to you. Willful false statements in responses to this data collection are punishable by fine and/or imprisonment (U.S. Code, Title 18, Section 1001). B-3 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 Uploading supporting documents is optional and encouraged. For example, you may find it more efficient to send your price schedules and/or discount schedules that do not easily fit into the table format the Bureau provided. Rather than typing the specifics into one spreadsheet cell, you can submit your own documentation along with the spreadsheet at the time you file your responses. If you opt to provide an attachment in lieu of entering your responses in the corresponding cells in the spreadsheet template, enter a clear description of the attachment that contains the relevant information. All sums should be summed to an annual level for that calendar year. All averages should be averages of monthly values or averages as described. All row numbers refer to the spreadsheet rows, not the row number within the table. 1. Subscriber Information: On the second tab ( Subscriber Info ), complete the following tables: " Table 1.1 This table asks you to report your customer usage (both Lifeline and non-Lifeline) amounts for both data and voice for the specified years o Report the average number of subscribers for each of the usage categories listed in the table § As an example:  Total customers who average more than or equal to 1 GB & less than 2 GB usage per month' should be the total number of customers you have whose average use per month was between 1.0000 and 1.9999 GB § To calculate this average, first count the number of subscribers in each usage tier each month § For example, a customer that used 0.5 GB one month and 3.5 GB another month would count among the  less than 1 GB tier in the first month and in the  more than or equal to 3 GB & less than 4 GB usage per month in the second month § Once you have calculated the total customers in each usage tier for each month, you will then sum up the 12 monthly totals for that tier and divide by 12; this will give you the average for that usage tier for that calendar year o Do the above steps for each of the 11 different usage categories for data and 8 different usage categories for voice B-4 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 " Table 1.2 This table asks you to report your Lifeline customer usage amounts for both data and voice over the past 5 years o This table is the same as Table 1.1, but the totals should include only your Lifeline customers o If you cannot segment your Lifeline customers and at least 90% of your subscriber base is Lifeline customers, then you should report the averages across your entire customer base (or the same values as Table 1.1) § Values should only be the same as Table 1.1 for years where the average monthly percentage of Lifeline subscribers is 90% or greater o If you cannot segment your Lifeline customers and Lifeline customers are less than 90% of your customer base, then leave this table blank " Table 1.3 This table asks you to report your customer data allowance (or usage caps) over the past 5 years, for both your entire customer base and your Lifeline customers o Report the average number of subscribers per month with a monthly data usage allowance § Row 4 should be the total across your entire customer base (and for whom a usage allowance exists) § Row 7, is the same question as row 4 but should be the total for your Lifeline customers only § If you cannot segment your Lifeline customers and at least 90% of your subscriber base is Lifeline customers, then you should report the averages across your entire customer base (or the same values as row 4) § Only use the values across your entire customer base for years where the average monthly percentage of Lifeline subscribers is 90% or greater § If you cannot segment your Lifeline customers and Lifeline customers are less than 90% of your customer base, then leave this row blank o Report the average number of subscribers per month who exceeded their monthly data usage allowance § Row 5 should be the total across your entire customer base (and for whom a usage allowance exists) § Row 8 is the same question as row 6, but should be the total for your Lifeline customers only § If you cannot segment your Lifeline customers and at least 90% of your subscriber base is Lifeline customers, then you should report the averages across your entire customer base (or the same values as row 5) B-5 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 § Values should only be the same as row 5 for years where the average monthly percentage of Lifeline subscribers is 90% or greater § If you cannot segment your Lifeline customers and Lifeline customers are less than 90% of your customer base, then leave this row blank o Report the average amount customers exceeded their monthly data usage allowance by (report the per month per user average); this is only for users who had an allowance and exceed it § For example: first, for each month determine which subscribers had a usage allowance and exceeded it; second determine how much each subscriber exceeded his or her cap by that month; third sum up all of the excess GB that month and divide it by the total subscribers found in part one. Then take the average of the 12 months for the respective calendar year. § Row 6 should be the total across your entire customer base (and for whom a usage allowance exists) § Row 9 is the same question as row 6, but should be the total for your Lifeline customers only § If you cannot segment your Lifeline customers and at least 90% of your subscriber base is Lifeline customers, then you should report the averages across your entire customer base (or the same values as row 6) § Values should only be the same as row 6 for years where the average monthly percentage of Lifeline subscribers is 90% or greater § If you cannot segment your Lifeline customers and Lifeline customers are less than 90% of your customer base, then leave this row blank o Row 10 asks for the average number of subscribers per month who do not have a data usage allowance § This total should be across your entire customer base § This total includes prepaid subscribers that do not have a set allowance each month o Row 11 asks for the average number of Lifeline subscribers per month who do not have a data usage allowance § Examples of customers who do not have a data usage allowance are: those with pay-as-you-go plans that have no set monthly usage; or those with unlimited plans that have no usage-dependent throttling or reduction in connection speeds, or higher costs § This total should be just across your Lifeline subscriber base § This total includes prepaid Lifeline subscribers that do not have a set allowance each month B-6 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 § If you cannot segment your Lifeline customers and at least 90% of your subscriber base is Lifeline customers, then you should report the averages across your entire customer base (or the same values as row 10) § Values should only be the same as row 10 for years where the average monthly percentage of Lifeline subscribers is 90% or greater § If you cannot segment your Lifeline customers and Lifeline customers are less than 90% of your customer base, then leave this row blank 2. Mobile Virtual Network Operator (MVNO) Providers: This section applies only to MVNOs or service resellers, and asks for your network costs, meaning the costs incurred to provision service, including both direct and indirect, or shared network costs. Network costs include the costs of wholesale services necessary to provide retail services, e.g., purchases of wholesale call minutes, or gigabytes of data or similar, would all be network costs. All overhead costs should be excluded from the values in this section. Examples of costs excluded from this section are advertising and customer outreach, customer billing costs, and other general and administrative costs. Report costs that are  only for the provision, maintenance, and upgrading of facilities and services for which the [Universal Service] support is intended, as provided by 47 U.S.C. § 254(e). Exclude any costs that do not meet that requirement. On the third tab ( MVNO Providers ), complete the following tables: " Table 2.1: This table asks you to report the costs paid to network operators for network access for your customers for both broadband and voice services o Row 4 should be the total GB of data you purchased that year o Row 5 asks for the total amount you paid for the data; this should be the wholesale costs for GBs totaled for that year (rounded to the nearest dollar) o Row 6 should be the total number of voice minutes you purchased that year o Row 7 asks for the total amount you paid for voice minutes; this should be the wholesale costs for voice minutes totaled for that year o Rows 8 through 11 repeat the four above questions, but ask for the totals to be specifically for Lifeline subscribers and those respective costs o If you cannot segment your Lifeline customers and at least 90% of your subscriber base is Lifeline customers, then you should report the averages across your entire customer base (or the same values as rows 4- 7) o The values should only be the same as rows 4-7 for years where the average monthly percentage of Lifeline subscribers is 90% or greater B-7 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 o If you cannot segment your Lifeline customers and Lifeline customers are less than 90% of your customer base, then leave this table blank " Table 2.2: This table asks you a series of yes or no questions regarding both your data and voice networks that will then determine which of the other tables on this tab you will be required to answer o Choose yes or no from the drop down for each of the 8 questions o Please note if you answer yes to any questions between 2.2a and 2.2h you will need to fill out an additional table on this tab " Table 2.3: This table asks you specific details regarding price variations for the wholesale minutes and/or GB you purchased between 2016 and 2020; this would include any quantity- based discounts you received o Only fill out this table if you answered yes to 2.2a o Report all price variations based on quantity o The price variation should be calculated as: (final price - the standard price) / the standard price; so for example if you paid $90 but the standard price was $100, you would report this is as -.1 or  10% o Column M is optional, and refers to the name or code you use to refer to this specific price variation o List every breakpoint that is associated with a different price variation o Indicate if this information is applicable to GB or minutes o List the years from 2016 to 2020 for which this price variation was available o Use the text field in column R to indicate any other specifics for which the price variation depends on or any information you would like to include o If you do not have price variations based on quantity enter  N/A " Table 2.4: This table asks you details regarding any rates you paid or discounts you received between 2016 and 2020 on wholesale minutes and/or GB that were specific to Lifeline users o Only fill out this table if you answered yes to 2.2b o Report and explain any rates or discounts specific to Lifeline customers and/or usage o List both the price variation (or discount amount) and any other pertinent information o If there are no specific rates or discounts for Lifeline customers enter  N/A B-8 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 " Table 2.5: This table asks you specific details regarding price variations or discounts for the wholesale minutes and/or GB you purchased between 2016 and 2020 that are specific to a particular region or geographic unit o Only fill out this table if you answered yes to 2.2c o Report price variations based on geographic areas o The price variation should be calculated as: (final price - the standard price) / the standard price; so for example if you paid $90 but the standard price was $100, you would report this is as -.1 or  10% o Column V is optional, and refers to the name or code you use to refer to this specific price variation o Indicate the geographic area included for each variation in price; this can be a list of included regions, states, MSAs, counties, or ZIP codes § Include rural and Tribal area-specific rates, discounts, or prices if applicable § If you include a list, separate the entities with a semi colon o For each geographic area indicate if the price variation is relevant for minutes or GB o List the years from 2016 to 2020 for which this price variation was available o Use the text field in column AA to indicate any other specifics for which the price variation depends on or any information you would like to include o Column AA should be used to describe what areas are encompassed in any general regional terms used (i.e. rural or Tribal) o If you do not have price variation by geographic regions enter  N/A " Table 2.6: This table asks for details on additional data and/or voice network costs you had between 2016 and 2020 (other than wholesale minutes and GB) that are not included in overhead costs; examples of these costs could be: fixed payments made to the network operator, or network costs incurred by the MVNO) o Only fill out this table if you answered yes to 2.2d o Explain the cost type or category o Include the years between 2016 and 2020 that these costs were relevant o Include the total cost amount for this cost type o Provide additional information or explanation in column AF for these costs o If you do not have any additional network costs beyond wholesale minutes and GB then leave this table (and Table 2.7 and 2.8) enter  N/A " Table 2.7: B-9 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 This table asks you to explain how the additional network costs indicated in part 2.2d and Table 2.6 are related (if at all) to your Lifeline subscribers o Only fill out this table if you answered yes to 2.2e o Detail which costs are related to Lifeline usage or customer base o Explain why your Lifeline subscribers lead to higher network costs (excluding their wholesale minutes and/or GB and any overhead support they may require, as those are asked in other questions) o If your additional network costs are not specific to Lifeline subscribers then enter  N/A " Table 2.8: This table asks you to explain how the additional network costs indicated in part 2.2d and Table 2.6 are related (if at all) to geographic regions o Only fill out this table if you answered yes to 2.2f o Indicate the geographic area included for each discount; this can be a list of included regions, states, MSAs, counties, or ZIP codes § Include rural and Tribal area-specific rates, discounts, or prices if applicable § If you include a list, separate the entities with a semi colon o Explain the cost type or category o Include the total cost amount for this cost type o Provide additional information or explanation in column AM for these costs (for example the years between 2016 and 2020 that these costs were relevant to these specific geographic areas) o If your additional network costs do not vary by geographic region then enter  N/A " Table 2.9: This table asks you to detail the network costs you indicated in 2.2g; these are the costs you incurred from purchasing GB for data and/or voice minutes that were available to a Lifeline customer in their data or voice allowance but were never used o Only fill out this table if you answered yes to 2.2g o Row 4 asks for the total GB purchased for Lifeline subscribers that were not used by a Lifeline end-user o Row 5 asks for the wholesale costs of the GB outlined in row 4 o Row 6 asks for the total voice minutes purchased for Lifeline subscribers that were not used by a Lifeline end-user o Row 7 asks for the wholesale costs of the voice minutes outlined in row 6 o If you did not incur any costs for unused GB or voice minutes specifically for Lifeline customers then enter  N/A B-10 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 3. Facilities-Based Providers: This section asks for your network rates (prices) at which network access is sold on a wholesale basis to MVNOs. Separately, report the underlying cost of provisioning service. For the cost of provisioning service, we are seeking a cost comparable to the wholesale rates  one that averages over the lifetime all the equipment necessary to deliver service, allocated on a subscriber basis. On the fourth tab ( Facilities-Based Providers ), complete the following tables: " Table 3.1: This table asks you to report the costs paid by MVNOs to access your network for both broadband and voice services o Row 4 should be the total GB you sold that year to MVNOs o Row 5 asks for the total amount you received for GB; this should be the wholesale revenue for GBs totaled for that year o Row 6 should be the total number of minutes you sold that year to MVNOs o Row 7 asks for the total amount you received for minutes; this should be the wholesale revenue for minutes totaled for that year o Rows 8 through 11 repeat the above four questions, but ask for the totals to be specifically for end-users who are Lifeline subscribers and that respective revenue § If you do not have specific rates for Lifeline end-users, then enter  N/A " Table 3.2: This table asks you a series of yes or no questions regarding your wholesale prices for data and minutes that will then determine which of the tables on this tab you will be required to answer o Choose yes or no from the drop down for each of the 3 questions o Please note if you answer yes to questions 3.2a, 3.2b, or 3.2c you will need to fill out an additional table on this tab " Table 3.3: This table asks you specific details of any quantity-based price variations (or discounts) you offered between 2016 and 2020 on your wholesale minutes and/or GB sold o Only fill out this table if you answered yes to 3.2a o Report all price variations based on quantity o The price variation should be calculated as: (final price - the standard price) / the standard price; so for example if you paid $90 but the standard price was $100, you would report this is as -.1 or  10% B-11 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 o Column M is optional, and refers to the name or code you use to refer to this specific price variation o List every breakpoint that is associated with a price variation o Indicate if this information is applicable to GB or minutes o List the years from 2016 to 2020 for which the price variation was available o Use the text field in column R to indicate any other specifics for which the price variation depends on or any additional explanation o If you do not have price variations based on quantity then enter  N/A " Table 3.4: This table asks you specific details of any geographic-based price variations (or discounts) you offered between 2016 and 2020 on your wholesale minutes and/or GB sold o Only fill out this table if you answered yes to 3.2b o Report all price variations based on geographic areas o The price variation should be calculated as: (final price - the standard price) / the standard price; so for example if you paid $90 but the standard price was $100, you would report this is as -.1 or  10% o Column T is optional, and refers to the name or code you use to refer to this specific price variation o Indicate the geographic area included for each price variation offered; this can be a list of included regions, states, MSAs, counties, or ZIP codes § Include rural and Tribal area-specific rates, discounts, or prices if applicable § If you include a list, separate the entities with a semi colon o For each geographic area indicate if the price variation is for minutes or GB o List the years from 2016 to 2020 for which the price variation was available o Use the text field in column Y to indicate any other specifics for which the price variation depends on or any additional explanation o If you do not offer discounts for any geographic region then enter  N/A " Table 3.5: This table asks you specific details of any price variations (or discounts) you offered between 2016 and 2020 on wholesale minutes and/or GB specifically for Lifeline users o Only fill out this table if you answered yes to 3.2c o Report and explain any variations in rates or discounts specific to Lifeline customers or Lifeline usage o Include both the price variation and any other pertinent details o If there is no specific price variation for Lifeline customers, then enter  N/A B-12 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 " Table 3.6: This table asks you your total network costs per month per user between 2016 and 2020 o Row 5 asks for your average network costs per month per user between 2016 and 2020 for urban / non-Tribal areas o Row 6 asks for your average network costs per month per user between 2016 and 2020 for urban / Tribal areas o Row 7 asks for your average network costs per month per user between 2016 and 2020 for rural / Tribal areas o Row 8 asks for your average network costs per month per user between 2016 and 2020 for rural / non-Tribal areas o If your network costs do not vary by geographic categories then enter  N/A o Please note this table is not contingent on a yes/no question, and is required " Table 3.7: This table asks you to explain how your network costs and/or your network cost allocations vary by geographic area type o Use the text field in row 4 to indicate any other specifics, caveats, or information regarding the average network costs per month per user for that year o Use the text fields in row 5 through 8 to explain if or how network cost allocations differ by rural / non-rural and tribal / non-tribal areas o If your network costs do not vary by rurality or for tribal areas, then enter  N/A o Please note this table is not contingent on a yes/no question, and is required 4. Overhead Costs Report overhead costs below, including sales, marketing, general and administrative, and any other cost not captured by the network costs detailed on previous tabs. However, exclude costs that do not meet the requirements of 47 U.S.C. § 254 (e). Report costs that are  only for the provision, maintenance, and upgrading of facilities and services for which the [Universal Service] support is intended. On the fifth tab ( Overhead Costs ), complete the following tables: " Table 4.1: This table asks for your total overhead costs and total users supported by those overhead costs over the past 5 years. o This should include all operating costs other than network costs and should exclude the cost of capital and interest; depreciation and amortization; capital expenditures; and adjustments to balance sheet values B-13 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 o Wholesale costs for minutes and GB should be excluded from this section, as they are reported in other tables o Report in row 5 your total overhead costs averaged per month for that year o Report in row 6 the average number of monthly subscribers supported by those overhead costs for each year o Report in row 7 the incremental overhead costs required to support Lifeline subscribers § If there are no incremental overhead costs, enter $0 § If you are unable to break-out overhead costs for Lifeline subscribers, but you know there are additional overhead costs, leave blank and explain in row 8 o Explain in row 8 detail the reasons for the incremental costs in overhead for Lifeline customers " Table 4.2: o Indicate which categories are included in your overhead cost calculations o Answer from the yes / no drop down o The cost categories listed may not be mutually exclusive in your records or data; however, we are only concerned if they are included or excluded from your totals " Table 4.3: o If you answered yes to 4.2h, you must fill out this table o Please detail the other categories of overhead costs that are not already indicated in Table 4.2 o If you answered no to 4.2h, please leave this table blank B-14 DRAFT Final version will be sent to respondents via email Appendix B DA 20-1529 Confidentiality As stated in the Order, the responses to the questionnaire will be treated as being filed in confidence, that is, being filed with a request that the responses not be made routinely available for public inspection pursuant to 47 CFR § 0.459. Certification & Submission Submissions should be accompanied by a certification by an officer of the provider that based on information and belief formed after reasonable inquiry the statements and information contained in the submission are true, accurate, and complete. Please indicate the name of the certifying official and the certification date on the first tab. Email the completed excel file and any supporting information to: LifelineCollection@fcc.gov B-15 DRAFT Final version will be sent to respondents via email