DIRECTIONS FOR COMPLETING 2015 Annual Federal Universal Service Fund Charge/Fee Waiver Certification ATTACHMENT(s) A and B

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1 DIRECTIONS F COMPLETING 2015 Annual Federal Universal Service Fund Charge/Fee Waiver Certification ATTACHMENT(s) A and B PLEASE READ BEFE COMPLETING YOUR CERTIFICATION: Before you begin completing your Certification, please decide whether you will submit your Certification and all supporting materials by using the Excel workbook template available from AT&T, or whether you will submit your Certification and all supporting materials via fax or hard copy. The format for submission is substantially different from the format for fax or hard copy submission. submission is strongly encouraged, particularly if you have multiple Filer IDs. GENERAL DIRECTIONS: A. If you will submit using 1. Download the correct Excel workbook template from AT&T. A template for submission of your 2015 Annual FUSF Charge/Fee Waiver Certification ( 2015 FUSF Certification ) and an Excel workbook template for Attachment A and Attachment B is available on the following AT&T websites: AT&T Prime Access [ and AT&T CLEC OnLine [ Note: the workbook template for submission of your 2015 FUSF Certification and supporting materials contains only five (5) tabs. Customers with multiple Filer IDs may submit one 2015 Certification via for all Filer IDs, but must use a separate 2015 Certification for each Filer ID if submitted by fax or hard copy. 2. Complete all applicable portions of the five tab Excel workbook template. If you list Exempt Services, submit one, single Attachment A that includes all your purchases from any of the AT&T companies from which you purchase services. If you list purchases that are NOT Exempt Services, submit one single Attachment B that includes all of your purchases from any of the AT&T companies that will accept Attachment B, plus one single Attachment A that includes all of your purchases from any AT&T company that does NOT accept Attachment B. You must use one of the following file names to save your workbook: a. If you checked box 3(a) on your 2015 FUSF Certification, please name your Excel file 2015 FUSF ATT A -, where the blank is for your CUSTOMER name. b. If you checked box 3(b) on your 2015 FUSF Certification, please name your Excel file 2015 FUSF ATT B -, where the blank is for your CUSTOMER name. c. If you checked box 3(c) on your 2015 FUSF Certification, please name your Excel file 2015 FUSF ATT A AND B -, where the blank is for your CUSTOMER name. 3. Print and Scan. After completing the 2015 Excel workbook FUSF Certification and all supporting materials: - print only your completed 2015 FUSF Waiver/Certification tab, - sign and date your printed 2015 FUSF Waiver/Certification pages using BLACK INK, - scan the completed and signed 2015 FUSF Waiver/Certification, Page 1 of 14

2 - save the scan as a.pdf file named 2015 FUSF Certification -, where the blank is for your CUSTOMER name Attach both the entire 2015 FUSF Waiver/Certification Excel Workbook file you created in step number 2, above, and the signed and scanned 2015 FUSF Waiver/Certification.pdf file you created in step number 3, above, to an with your CUSTOMER name in the subject field. Send this to NOTES: Before ing, check that you saved your Excel Workbook with the appropriate name specified in step 2, above, and your.pdf file with the name specified in step 3, above. Be sure you have included your CUSTOMER name in the subject field of your . If any required supporting material(s) are missing from your submission, AT&T will reject your submission and require you to complete any missing portion(s) then re-submit your 2015 FUSF Certification and all supporting materials in a single . B. If you will submit by fax or hard copy: 1. Complete paper copies of the 2015 Annual Federal Universal Service Fund Charge/Fee Waiver Certification and all necessary attachments. Use the specific instructions supplied throughout these Directions. When completing all forms, please type all forms; please sign all forms using BLACK INK ONLY. Templates for fax or hard copy submission of your 2015 FUSF Certification, Attachment A and Attachment B or a combined Excel workbook containing Attachments A and Attachments B are available on the following AT&T websites: AT&T Prime Access [ and AT&T CLEC OnLine [ Note: the Excel workbook template for the combined fax or hard copy submission of the Attachment(s) to your 2015 FUSF Certification contains twenty-seven (27) tabs. 2. Sign and date your 2015 FUSF Certification and each Attachment A and Attachment B. 3. Submit all materials using the instructions on page 14 of these Directions. SPECIFIC INSTRUCTIONS F COMPLETING FMS: REGARDLESS OF SUBMISSION METHOD: IMPTANT: ATTACHMENT B MAY ONLY BE USED F CERTAIN PURCHASES. IF ATTACHMENT B IS NOT EXPLICITLY STATED AS ACCEPTED IN THE APPROPRIATE PURCHASES FROM HEADING BELOW, THEN YOU MAY ONLY USE ATTACHMENT A TO CERTIFY YOUR PURCHASES FROM THAT AT&T COMPANY. NOTE: Any of the services purchased by you and used for your own internal use or that of an Affiliate (where permitted by the terms of the agreement with AT&T) or for information services only, are NOT Exempt Services (that is, they are subject to the FUSF FEE) and the related billing account number(s), circuit identification information and/or telephone number(s) should be excluded from Attachment A or provided on Attachment B (if accepted by the AT&T company from which you purchase the particular service) Page 2 of 14

3 Purchases from FCC Tariffs or AT&T Interstate Access Guidebook Attachment A or Attachment B: Combine ALL purchases you certify are Exempt Services on ONE Excel Attachment A, and all purchases that are NOT Exempt Services on ONE Excel Attachment B. Do NOT submit more than ONE Excel Attachment A and ONE Excel Attachment B for all your purchases from any of the AT&T companies mentioned in these Directions. Please include ALL Access Carrier Name Abbreviations [ACNA(s), three characters, usually alpha] associated with your purchases. Note that certain usage sensitive purchases are billed using Operating Company Number(s) (OCNs) / Alternate Exchange Carrier Number(s) (AECNs) [OCN / AECN identifiers are four digits, usually numeric], so please include ALL OCN(s) and AECN(s) associated with your purchases. Refer to the chart on page 4. Please submit a separate Attachment A or Attachment B for services purchased from EACH of the seven FCC Tariffs/Interstate Access Guidebook Parts listed in this section of these Directions. Example: If you are claiming exemption for services purchased from the BellSouth FCC No. 1 and the Ameritech FCC No. 2, you must provide an Attachment A or B for the services purchased from BellSouth s FCC No. 1 and a separate Attachment A or B for the services purchased from Ameritech s FCC No. 2. If you are claiming exemption(s) for services purchased from all six (6) of the following FCC tariffs/interstate Access Guidebook Parts, you must submit a total of seven (6) Attachments A or Attachment(s) B. Please include ALL Access Carrier Name Abbreviations [ACNA(s), three characters, usually alpha] associated with your purchases. Note that certain usage sensitive purchases are billed using Operating Company Number(s) (OCNs) / Alternate Exchange Carrier Number(s) (AECNs) [OCN / AECN identifiers are four digits, usually numeric], so please include ALL OCN(s) and AECN(s) associated with your purchases. Refer to the chart on page 4. *** this portion of this page intentionally left blank *** Page 3 of 14

4 AT&T FCC Tariff/Interstate Access Guidebook BellSouth Telecommunications, Inc. F.C.C. No. 1 and/or Interstate Access Guidebook Part 11 Pacific Bell Telephone Company F.C.C. No. 1 and/or Interstate Access Guidebook Part 7 Nevada Bell Telephone Company F.C.C. No. 1 and/or Interstate Access Guidebook Part 8 Ameritech Operating Companies F.C.C. No. 2 and/or Interstate Access Guidebook Part 6 Southwestern Bell Telephone Company F.C.C. No. 73 and/or Interstate Access Guidebook part 9 AT&T Operating Company F.C.C. No. 1 and/or Interstate Access Guidebook part 5, section 5 Operating Territory Alabama Florida Georgia Kentucky Louisiana Mississippi N. Carolina S. Carolina Tennessee California Nevada Illinois Indiana Michigan Ohio Wisconsin Arkansas Kansas Missouri Oklahoma Texas Arkansas California Illinois Indiana Kansas Michigan Missouri Nevada Ohio Oklahoma Texas Wisconsin Example of Billing (X = any number) (Area Code) NXX-XXXX Note: character 4 is an alpha Ex. A Georgia account number might be 404 N (CABS bill) 072 XXX-XXXX 073 XXX-XXXX (CABS bill) 071 XXX-XXXX (CABS bill) 217 XXX-XXXX 219 XXX-XXXX 313 XXX-XXXX 216 XXX-XXXX 414 XXX-XXXX Note: character 4 is an alpha. Ex. An Illinois account number might be 217 S (CABS bill) 310 XXX-XXXX 210 XXX-XXXX 110 XXX-XXXX 120 XXX-XXXX 410 XXX-XXXX 510 XXX-XXXX 610 XXX-XXXX 710 XXX-XXXX EX: A Texas account number might be (CABS bill) XX.ABCD.XXXXXX (Circuit ID) Page 4 of 14

5 Purchases from Interconnection Agreement(s), Applicable State Tariff(s), Price List(s) or Guidebook(s) Attachment A or Attachment B: REGARDLESS OF SUBMISSION METHOD: If you are a Payphone Service Provider and have not been granted de minimus status under the FCC s Instructions, you may ONLY certify your purchases using Attachment A. Payphone Service Providers do not need to list ANIs or TNs for their purchase of any service categorized with a payphone class of service, but should enter payphone on the appropriate line in the far right column of Attachment A. If a Payphone Service Provider also purchases any service not categorized with a payphone class of service (for example, a T-1), you must certify any such service you claim is exempt by providing all information required on your Attachment A for such service. Combine ALL purchases you certify are Exempt Services on ONE Excel Attachment A, and all purchases that are NOT Exempt Services on ONE Excel Attachment B. Do NOT submit more than ONE Excel Attachment A and ONE Excel Attachment B for all your purchases from any of the AT&T companies mentioned in these Directions. Please include ALL Operating Company Number(s) (OCNs)/ Alternate Exchange Carrier Number(s) (AECNs) [OCN/ AECN identifiers are four digits, usually numeric] associated with your purchases. Refer to the chart on page 6. Your purchases from Interconnection Agreement(s), applicable state tariffs, price list(s) or guidebook(s) that involve FUSF assessable interstate charges (see chart on page 6 for additional details) resulting from: - Purchases from EACH of the companies listed in this sub-paragraph must be reported on a separate Attachment A Attachment B for EACH of: AT&T Illinois; AT&T Indiana; AT&T Michigan; AT&T Ohio; AT&T Wisconsin; AT&T Nevada; and AT&T California. - Purchases from AT&T Arkansas, AT&T Kansas, AT&T Missouri, AT&T Oklahoma and AT&T Texas may be grouped on one Attachment A Attachment B. - Purchases from AT&T Alabama, AT&T Florida, AT&T Georgia, AT&T Kentucky, AT&T Louisiana, AT&T Mississippi, AT&T North Carolina, AT&T South Carolina and AT&T Tennessee may be grouped on one Attachment A Attachment B. Please include ALL Operating Company Number(s) (OCNs)/ Alternate Exchange Carrier Number(s) (AECNs) [OCN/ AECN identifiers are four digits, usually numeric] associated with your purchases Page 5 of 14

6 AT&T service area AT&T Illinois AT&T Indiana AT&T Michigan AT&T Ohio AT&T Wisconsin AT&T Nevada AT&T California FUSF Assessable Charges (Interstate per FCC) EUCL Consumer EUCL Single-Line Business EUCL Multi-line Business EUCL Payphone EUCL ISDN BRI EUCL ISDN PRI EUCL DTS PICC Manual/Mechanized EUCL Consumer EUCL Single-Line Business EUCL Multi-line Business EUCL Payphone EUCL ISDN BRI EUCL ISDN PRI PICC Manual/Mechanized Example of Billing Account Number (X = any number) (040) LXX-XXXX XXX (040) LXX-XXXX XXX (040) LXX-XXXX XXX (040) LXX-XXXX XXX (040) LXX-XXXX XXX 123-3XX-XXXX 023-7XX-XXXX (North) 023-4XX-XXXX (South) AT&T Arkansas AT&T Kansas AT&T Missouri AT&T Oklahoma AT&T Texas AT&T Alabama AT&T Florida AT&T Georgia AT&T Kentucky AT&T Louisiana AT&T Mississippi AT&T North Carolina AT&T South Carolina AT&T Tennessee EUCL Consumer EUCL Single-Line Business EUCL Multi-line Business EUCL Payphone EUCL ISDN BRI EUCL ISDN PRI PICC Manual/Mechanized EUCL Single-Line Business EUCL Multi-line Business EUCL Payphone EUCL ISDN PRI EUCL ISDN BRI EUCL Residence PIC Change Charge Residence PIC Change Charge Business Arkansas 501 LXX-XXXX Kansas 316 LXX-XXXX Missouri 314 LXX-XXXX Oklahoma 405-LXX-XXX Texas Dallas 214 LXX-XXXX Houston 713 LXX-XXXX San Antonio 210 LXX-XXXX Example of Q account for the state of Florida: 305 QXX-XXXX-XXX Example of Billing for the state of Florida: 305-NXX-XXXX-XXX Page 6 of 14

7 Purchases from AT&T Long Distance Guidebooks Attachment A ONLY: Purchases from AT&T Long Distance Service Guidebooks Attachment A ONLY: Combine ALL purchases you certify are Exempt Services on ONE Excel Attachment A. Do NOT submit more than ONE Excel Attachment A for all your purchases from any of the AT&T companies mentioned in these Directions. Attachment B will NOT be accepted for purchases from AT&T Long Distance Guidebooks or AT&T Long Distance Service Guidebooks. Please include billing account number(s) or telephone number(s) you claim are exempt. Refer to the chart at the bottom of this page. Use the chart at the bottom of this page to determine the type of billing/account information you must provide on EACH Attachment A. Attachment B will NOT be accepted for purchases from AT&T Long Distance Guidebooks or AT&T Long Distance Service Guidebooks. ONE Attachment A is required for ALL services purchased from AT&T Long Distance. A separate Attachment A is required for ALL services purchased from AT&T Long Distance Service. Please include billing account number(s) or telephone number(s) you claim are exempt. Services purchased from AT&T Long Distance or AT&T Long Distance Service Private Line ATM Frame Relay Example of Account number or other info required (X = any number) XX XXX XX XXX This is called: the Billing Number on the bill *** this portion of this page intentionally left blank *** Page 7 of 14

8 Purchases from AT&T Long Distance Service Wholesale Services Supplements (BellSouth Long Distance, Inc.) Attachment A ONLY: Combine ALL purchases you certify are Exempt Services on ONE Excel Attachment A. Do NOT submit more than ONE Excel Attachment A for all your purchases from any of the AT&T companies mentioned in these Directions. Attachment B will NOT be accepted for purchases from AT&T Long Distance Service Wholesale Services Supplements. Please include billing account number(s) or telephone number(s) you claim are exempt. Refer to the chart at the bottom of this page. Use the chart at the bottom of this page to determine the type of billing/account information you must provide on ONE Attachment A. Attachment B will NOT be accepted for purchases from AT&T Long Distance Service Wholesale Services Supplements. Please include your Customer number and any service number(s) you claim are exempt. Services purchased from AT&T Long Distance Service through a Wholesale Services Supplement Dedicated Inbound Dedicated Outbound Frame Relay International Wholesale Private Line Switched Outbound Switched Inbound Example of Account number or other info required XXXX (X = any number) This is called: the Customer number *** this portion of this page intentionally left blank *** Page 8 of 14

9 Purchases from AT&T Diversified Group Attachment A ONLY: Combine ALL purchases you certify are Exempt Services on ONE Excel Attachment A. Do NOT submit more than ONE Excel Attachment A for all your purchases from any of the AT&T companies mentioned in these Directions. Attachment B will NOT be accepted for purchases from AT&T Diversified Group. Please include billing account number(s) or telephone number(s) you claim are exempt. Refer to the chart at the bottom of this page. Use the chart at the bottom of this page to determine the type of billing/account information you must provide on ONE Attachment A. Attachment B will NOT be accepted for purchases from AT&T Diversified Group. Please include your Customer number and any service number(s) you claim are exempt. Services purchased from AT&T Diversified Group Intelligent Network Gateway Services (SS7 Circuits and ports) Wholesale Operator Assistance / Directory Assistance Example of Billing (X = any number) XXXX or XXXXX OPNKXXXX *** this portion of this page intentionally left blank *** Page 9 of 14

10 Purchases from AT&T Service Guides or Contracts (AT&T Corp.) Attachment A ONLY: Purchases from AT&T Alaska Attachment A ONLY: Purchases from AT&T of Puerto Rico, Inc. Attachment A ONLY: Combine ALL purchases you certify are Exempt Services on ONE Excel Attachment A. Do NOT submit more than ONE Excel Attachment A for all your purchases from any of the AT&T companies mentioned in these Directions. Attachment B will NOT be accepted for purchases from AT&T Service Guides or Contracts (AT&T Corp.), AT&T Alaska or AT&T of Puerto Rico, Inc. Please include billing account number(s) or telephone number(s) you claim are exempt. Refer to the chart on page(s) 10 through 12. Use the chart on pages 10 through 12 to determine the type of billing/account information you must provide on EACH Attachment A. Please contact your AT&T Sales Representative for assistance with a service not listed. Attachment B will NOT be accepted for purchases from AT&T Service Guides or Contracts (AT&T Corp.), AT&T Alaska or AT&T of Puerto Rico, Inc. A separate Attachment A is required for EACH TYPE of service purchased from AT&T Corp. A separate Attachment A is required for EACH TYPE of service purchased from AT&T Alaska. A separate Attachment A is required for EACH TYPE of service purchased from AT&T of Puerto Rico, Inc. Please include your Customer number and any service number(s) you claim are exempt. Service purchased from AT&T Corp. AT&T Alaska AT&T of Puerto Rico, Inc. AT&T Asynchronous Transfer Mode (ATM) Example of Account number or other info required (A = any letter; X = any number) XX XXX XX XXX = XXXXXX This is called: Billing Number If all Bill Groups are resold, only the MCN is needed. If some Bill Groups are resold but other Bill Groups are used (continue) Page 10 of 14

11 Service purchased from AT&T Corp. AT&T Alaska AT&T of Puerto Rico, Inc. Example of Account number or other info required (A = any letter; X = any number) administratively or for information services, you must provide Billing Number(s) for the resold service(s) on Attachment A. This is called: AT&T Clear Advantage 020 3XX-XXXX-XXX AT&T CustomNet Service 019 XXX-XXXX-XXX 020 XXX-XXXX-XXX 030 XXX-XXXX-XXX 161 XXX-XXXX-XXX AT&T DCS including Private Line and Frame Relay AT&T SDN Service 800X-XXX-XXXX XX XXX XX XXX = XXXXXX If all Bill Groups are resold, only the MCN is needed. If some Bill Groups are resold and other Bill Groups are used administratively or for information services, you must provide Billing Number(s) for the resold services on Attachment A. AT&T DNS X-XXXX-XXX X-XXXX-XXX AT&T Execu-Bill Card XXXX-XXX Headquarters AT&T Frame Relay Services XX XXX XX XXX = XXXXXX Billing Number If all Bill Groups are resold, only the MCN is needed. If some Bill Groups are resold and other Bill Groups are used administratively or for information services, you must provide Billing Number(s) for the resold service(s) on Attachment A. (example: AMFX-AMFX22) AT&T Local Private Line AAAA-AAAAXX Services (TCG) AT&T Masterline Service NRA XXX-XXXX-XXX AT&T MEGACOM Service 176 XXX-XXXX-XXX AT&T MEGACOM Optimum X-XXXX-XXX X-XXXX-XXX AT&T MEGACOM Plus X-XXXX-XXX AT&T UniPlan X-XXXX-XXX Service AT&T MEGACOM 800 Service 146-XXX-XXXX-XXX 186-XXX-XXXX-XXX Page 11 of 14

12 Service purchased from AT&T Corp. AT&T Alaska AT&T of Puerto Rico, Inc. Example of Account number or other info required (A = any letter; X = any number) This is called: AT&T Network Connection Service (ANC) AT&T OneNet Service AT&T OneNet Inbound AT&T Ultravailable Network Service (UVN) AT&T Virtual Private Network (AVPN) AT&T Enhanced Virtual Private Network (EVPN) AT&T Virtual Telecommunications Network Service (VTNS) W05247XXXXXXX 100X-XXX-XXXX 191 XXX- XXXX = XXXXXX 831X XXX-XXXX VPXXX VPXXXX EVXXXXXX 8080 XXX-XXXX XX XXX XX XXX = XXXXXX CPID and OneNet Account Numbers found on the bill are both required on Attachment A. : If all Bill Groups are resold, only the MCN is needed. If some Bill Groups are resold and other Bill Groups are used administratively or for information services, you must provide Billing Number(s) for the resold service(s) on Attachment A. Billing Number. If All bill groups under one MCN are resold, just provide the MCN. AT&T 800 READYLINE 131 XXX-XXXX-XXX Service Advanced 800 Features 999-XXX-XXXX-XXX *** this portion of this page intentionally left blank *** Page 12 of 14

13 Purchases from AT&T Mobility Puerto Rico, Inc. Attachment A ONLY: Combine ALL purchases you certify are Exempt Services on ONE Excel Attachment A. Do NOT submit more than ONE Excel Attachment A for all your purchases from any of the AT&T companies mentioned in these Directions. Attachment B will NOT be accepted for purchases from AT&T Mobility Puerto Rico, Inc. Please include billing account number(s) or telephone number(s) you claim are exempt. Refer to the chart at the bottom of this page. Use the chart below to determine the type of billing/account information you must provide on Attachment A. A separate Attachment A is required for EACH TYPE of service purchased from AT&T Mobility Puerto Rico, Inc. Please contact your AT&T Sales Representative for assistance with a service not listed. Attachment B will NOT be accepted for purchases from AT&T Mobility Puerto Rico, Inc. Please include your Customer number and any service number(s) you claim are exempt. Service purchased from AT&T Mobility Puerto Rico, Inc. AT&T Local Private Line Service (Puerto Rico) AT&T Switched Ethernet Service (Puerto Rico) AT&T Wholesale Local Traffic Termination Services (Puerto Rico) AT&T Wholesale VoIP Services (Puerto Rico) Example of Account number or other info required (X = any number) A80XXXXX A90XXXXX A70XXXXX A30XXXXX This is called: Circuit ID Number within Billing PR0003XXXXXX Circuit ID Number within Billing PR0003XXXXXX Circuit ID Number within Billing PR0003XXXXXX Circuit ID Number within Billing PR0003XXXXXX Page 13 of 14

14 Purchases from AT&T Mobility Attachment A ONLY: Combine ALL purchases you certify are Exempt Services on ONE Excel Attachment A. Do NOT submit more than ONE Excel Attachment A for all your purchases from any of the AT&T companies mentioned in these Directions. Attachment B will NOT be accepted for purchases from AT&T Mobility. Please include billing account number(s) or telephone number(s) you claim are exempt. Refer to the chart on this page. A separate Attachment A is required for EACH TYPE of service purchased from AT&T Mobility. Please contact your AT&T Sales Representative for assistance with a service not listed. Attachment B will NOT be accepted for purchases from AT&T Mobility. Please include your Customer number and any service number you claim is exempt. Refer to the chart on this page. Service purchased from AT&T Mobility Example of Billing (X = any number; A = any letter) XXXXXXXXX or XXXXXXXXXXX or AAA or XXXXXXX-XXX-XX If you are unable to submit your completed 2015 Annual Federal Universal Service Fund Charge/Fee Waiver Certification via If you are unable to your completed 2015 Annual Federal Universal Service Fund Charge/Fee Waiver Certification form in accordance with General Directions Section A, paragraphs numbered 1 through 4 (see page 1 and the top of page 2 of these Directions), follow General Directions Section B, paragraphs numbered 1 through 3 (see page 2 of these Directions). You may either fax all signed and dated documents that comply with Section B, paragraphs 1 and 2 to or mail the signed and dated originals addressed to: AT&T, 529 S. 7 th Street, 2 nd floor, Springfield, IL Page 14 of 14