IMPORTANT: PLEASE READ INSTRUCTIONS FIRST

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1 FCC Form 555 Annual Lifeline Eligible Telecommunications Carrier Certification Form All carriers must complete all or portions of all sections Form must be submitted to USAC and filed with the Federal Communications Commission IMPORTANT: PLEASE READ INSTRUCTIONS FIRST Deadline: January 31st (Annually) Oregon State (An Eligible Telecommunications Carrier (ETC) must provide a certification form for each state in which it provides Lifeline service). 2 SAC codes 2 companies (see attached) Study Area Code(s) (SAC) ETC(s) TDS Telecommunications Corp, Inc. TDS Telecom, TDS Holding Company (s) OBA, Marketing or Other Branding (s) Affiliated ETCs (include names and SACs, attach see attached additional sheets if necessary) Provide a list of all ETCs that are affiliated with the reporting ETC. Affiliation shall be determined in accordance with section 3(2) of the Communications Act. That Section defines "affiliate" as "a person that (directly or indirectly) owns or controls, is owned or controlled by, or is under common ownership or control with, another person." 47 US.C. 153(2). See also 47 C.F.R For purposes of this filing, an officer is an occupant of a position listed in the article of incorporation, articles of formation, or other similar legal document. An officer is a person who occupies a position specified in the corporate by-laws (or partnership agreement), and would typically be president, vice president for operations, vice president for finance, comptroller, treasurer, or a comparable position. If the filer is a sole proprietorship, the owner must sign the certification Section I: All ETCs MUST COMPLETE SECTION 1-Initial Certification I certify that the company listed above has certification procedures in place either to: A) Review income and program-based eligibility documentation prior to enrolling a consumer in the Lifeline program, and that, to the best of my knowledge, the company was presented with documentation of each consumer's household income and/or program-based eligibility prior to his or her enrollment in Lifeline or B) Confirm consumer eligibility by relying upon access to a state database and/or notice of eligibility from the state Lifeline administrator prior to enrolling a consumer in the Lifeline program. I am an officer of th~ named above. I am authorized to make this certification for the Study Area(s) listed above. lnitiat-:::.ll.y

2 FCC Fonn 555 Section 2: All ETCs MUST COMPLETE SECTION 2-Annual Recertification Do not leave empty columns. If an ETC has nothing to report in a column, enter a zero. A B c Number of Number of Lines Claimed on Number of Subscribers claimed Subscribers Claimed on February FCC Form(s) 497 on lhe February FCC Form(s) February FCC Form(s) 497 of current Form lhat were initially enrolled in or current Form 555 calendar year provided to current Form 555 calendar year calendar year Wirellne Resellers Ir'\ "I /"'\ CX I u '--" Initial the certifications below that apply to your ETC and complete the tables corresponding to the certification below. Depending on the state, BOTH CERTIFICATION A AND B MAY APPLY A) I certify that the company listed above has procedures in place to recertify the continued eligibility of all of its Lifeline subscribers, and that, to the best of my knowledge, the company obtained signed certifications from all subscribers attesting to their continuing eligibility for Lifeline. Results are provided in the chart below. I am an officer of the company named above. I am authorized to make this certification for the Study Area(s) listed above. Initial D E F=D-E G H=(F+G) Number of Number of Number of Non- Number of Number of Subscribers Number of Subscribers ETC Subscribers Responding Subscribers De-enrolled or Subscribers Who Contacted Directly Responding to Subscribers Responding That Scheduled to be De- De-Enrolled Prior to Recertify ETC Contact They Are No Enrolled as a Result of to Recertification Eligibility Through Longer Eligible Non-Response or Attempt Attestation Ineligibility AND/OR In the space below, please list the program eligibility data sources, such as ETC access to a state database and/or notice of eligibility from the state Lifeline administrator or the Universal Service Administrative Company (USAC), and indicate for which qualifying programs (e.g., SNAP, SS!) these sources are used to verify subscriber eligibility. If any of subscribers are subsequently contacted directly by the ETC in an attempt to recertify eligibility, those subscribers should be listed in columns D through I as appropriate and not in columns J through L. B) I certify that the company listed above has procedures in place to re-certify consumer eligibility by relying on Of<.. f lj.. C,. Results are provided in the chart below. I am an officer of the co~med above. I am authorized to make this certification for the Study Area(s) listed above. lnitia~ J K L Number of Subscribers Number of Number of Subscribers Who Whose Eligibility was Subscribers De-Enrolled or De-Enrolled Prior to Reviewed By State Scheduled to be De-Enrolled as a Recertification Attempt Administrator Result of Finding of Ineligibility by ETC Access to Eligibility State Administrator, ETC Access to () Data or by USAC J I Eligibility Data or USAC I IV' I I OR C) I certify that my company did not claim federal low income support for any Lifeline subscribers for the February Form 497 data month for the current Form 555 calendar year. I am an officer of the company named above. I am authorized to make this certification for the Study Area(s) listed above. Initial 2

3 FCCFonn 555 Section 3: ALL ETCS MUST COMPLETE SECTION 3 - De-enroll percentage What is the percentage of subscribers de-enrolled for this ETC? M N 0 P=N+O Number of Number of Subscribers Number of Subscribers Total Number of Subscribers Claimed De- Enrolled or De- Enrolled or Subscribers De-Enrolled on February FCC Scheduled to be De- Scheduled to be De- or Scheduled to be De-E Form(s) 497 Enrolled as a Result of Enrolled as a Result of nrolled Non-Response or a Finding oflnellgibility Ineligibility (From Column A),.., (From Column H) f""'\ (From Column K) ol \ \.._.) I I 1 I Q = ((P+ M) * 100) Percentage of Subscribers De-Enrolled or Scheduled to be De-Enrolled that were Claimed on the February FCC Form(s) 497 JI --. I, I lo Section 4: ALL ETCS MUST COMPLETE APPROPRIATE CHECK BOX; PRE-PAID ETCS MUST COMPLETE ALL OF SECTION 4 Is the ETC Pre-Paid? Yes D No l./i (A Pre-Paid ETC does not assess or collect a monthly fee from its Lifeline subscribers) If yes, record the number of subscribers de-enrolled for non-usage by month in column S below. Non-Usage Results Applicable to Pre-Paid ETCs: January February March April May June July August September October November December R Month Subscribers De-Enrolled for Non-Usae:e s Signature Block: ALL ETCS MUST COMPLETE SIGNATURE FIELDS By signing below, I certify that the company listed above is in compliance with all federal Lifeline certification procedures. I am an officer of the company named above. I am authorized to make this certification for the Study Area(s) listed above. 3

4 FCC Form 555 Title of Officer Jennifer Lautenschleger Person Completing this Certification Form Joel P. Dohmeier Printed of Officer 1/30/2014 Date Contact Phone Number SAC ETC Identification ETC Asotin Telephone Co. Home Telephone Co. SAC Holding Com Jany (s) Holding Company SAC DBA, Marketing or Other Branding (sl 4

SAC FCC Form 555 November 2013 190217 300585 452171 361350 532404 522404 330844 230469 330849 220346 330851 361362 330856 250284 280448 220351 320744 330859 310685 401698 100005 320776 310672 320809

5 SAC FCC Form 555 November Approved by OMS Affiliated ETCs Amelia Telephone Corporation Arcadia Telephone Company Arizona Telephone Company Arvig Telephone Company Asotin Telephone Company (OR) Asotin Telephone Company (WA) Badger Telecom, LLC Barnardsville Telephone Company Black Earth Telephone Company, LLC. Blue Ridge Telephone Company Bonduel Telephone Company, LLC. Bridge Water Telephone Co. Burlington, Brighton & Wheatland Telephone Company, LLC Butler Telephone Company, Inc. Calhoun City Telephone Company, Inc. Camden Telephone and Telegraph Company, Inc. Camden Telephone Company, Inc. Central State Telephone Company, LLC Chatham Telephone Company Cleveland County Telephone Company, Inc. Cobbosseecontee Telephone Company Communications Corporation of Indiana Communications Corporation of Michigan Communications Corporation of Southern Indiana Concord Telephone Exchange, Inc Continental Telephone Company Decatur Telephone Company, Inc. Delta County Tele-Comm, Inc. Deposit Telephone Company, Inc. Dickeyville Telephone, LLC EastCoast Telecom of Wisconsin, LLC Edwards Telephone Company, Inc. The Farmers Telephone Company, LLC Grantland Telecom, LLC Hampden Telephone Company Happy Valley Telephone Company Hartland & St. Albans Telephone Company Home Telephone Company The Home Telephone Company of Pittsboro, Inc. Home Telephone Company, Inc. Hornitos Telephone Company Humphreys County Telephone Company Island Telephone Company Kearsage Telephone Company KMP d/b/a Mid-State Telephone Company Leslie County Telephone Company Lewis River Telephone Company, Inc. Lewisport Telephone Co. 5

SAC FCC Form 555 November 2013 300613 140058 170183 240533 522430 320788 123321 120047 432010 330881 361433 330909 330917 330915 287449 220375 193029 421928 140061 240535 250311 300645 431984 421934

6 SAC FCC Form 555 November Affiliated ETCs Little Miami Communications Corporation Ludlow Telephone Company Mahanoy & Mahantango Telephone Company McClellanville Telephone Company, Inc. McDaniel Telephone Company The Merchants and Farmers Telephone Company MCTA Merrimack County Telephone Company Mid-America Telephone, Inc. Mid-Plains Telephone, LLC Mid-State Telephone Company Midway Telephone Company, LLC Mt. Vernon Telephone Company, LLC Mosinee Telehphone Company Myrtle Telephone Company, Inc. Nelson-Ball Ground Telephone Company New Castle Telephone Co. New London Telephone Company Northfield Telephone Company Norway Telephone Co. Inc Oakman Telephone Company, Inc. Oakwood Telephone Company Oklahoma Communication Systems, Inc. Orchard Farm Telephone Company Oriskany Falls Telephone Corporation Peoples Telephone Company, Inc. Perkinsville Telephone Company, Inc. Port Byron Telephone Company Potlatch Telephone Company, Inc. Quincy Telephone Company Quincy Telephone Company Riverside Telecom, LLC S & W Telephone Company, Inc. Salem Telephone Co. Saluda Mountain Telephone Co. Scandinavia Telephone Company, LLC Service Telephone Co. Shiawassee Telephone Company Somerset Telephone Company Southeast Mississippi Telephone Company, Inc. Southeast Telephone Co. of Wisconsin, LLC Southwestern Telephone Company St. Stephen Telephone Company State Long Distance Telephone Company Stockbridge & Sherwood Telephone Company, LLC The Stoutland Telephone Company Strasburg Telephone Company Sugar Valley Telephone Company 6

SAC FCC Form 555 November 2013 290578 290575 330958 100007 300662 320829 150129 320830 120049 330963 150133 190253 100031 330968 100034 320837 240551 120050 361507 542323 310738 432034 539002 529001

7 SAC FCC Form 555 November Affiliated ETCs Tellico Telephone Company, Inc. Tennessee Telephone Company Tenney Telephone Company, LLC The Island Telephone Company The Vanlue Telephone Company Tipton Telephone Company, Inc. Township Telephone Company, Inc. Tri-County Communications Corporation Union Telephone Company Utelco, LLC. Vernon Telephone Company, Inc. Virginia Telephone Company Warren Telephone Company Waunakee Telephone Company, LLC. The West Penobscot Telephone and Telegraph Company West Point Telephone Company Williston Telephone Company Wilton Telephone Company, Inc. Winsted Telephone Company Winterhaven Telephone Company Wolverine Telephone Company Wyandotte Telephone Company UNITED STATES CELLULAR CORPORATION' YAKIMA MSA l.p. dba US CELLULAR UNITED STATES CELLULAR OPERATING CO. UNITED STATES CELLULAR CORPORATION USOC OF GREATER MISSOURI USCOC-NE US CELLULAR OPERATING COMPANY, LLC-TN NY RSA 2 CELLULAR PARTNERSHIP US CELLULAR OPERATING COMPANY, LLC - NC US CELLULAR OPERATING COMPANY, LLC- NH USCC- IL US CC-WV UNITED STATES CELLULAR OPERATING CO, LLC-VA USCC-BANGOR CELLULAR TEL. CO. USCC-USCOC OF OK RSA#10,1NC USCC - USCOC of Greater Iowa, Inc. ST. LAWRENCE SEAWAY RSA CELLULAR PARTNERSHIP 7

IMPORTANT: PLEASE READ INSTRUCTIONS FIRST Deadline: January 31st (Annually)

IMPORTANT: PLEASE READ INSTRUCTIONS FIRST Deadline: January 31st (Annually) Annual Lifeline Eligible Telecommunications Carrier Certification Form All carriers must complete all or portions of all sections Form must be submitted to USAC and filed with the Federal Communications