USAC
FCC Form 497 July 2008 Edition LIFELINE AND LINK UP WORKSHEET Approved by OMB 3060-0819 Avg. Burden Est. per Respondent: 3.0 Hrs. USAC Service Provider Identification Number (1) (3) Company Name: Mailing Address: (4) a) Submission Date b) Data Month Serving Area (2) Contact Name: Telephone Number: Fax Number: E-mail Address: c) Type of filing (Check one): d) State Reporting Original Revision Lifeline Tier 1 Low-Income Subscribers receiving federal Lifeline Support Tier 2 Low-Income Subscribers MoreTotal TLS. $. Total Link Up $. Total Dollars. $. If you have any questions, please call ... data contained in this form has been examined and reviewed and is true, ... Less
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