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DOC-324275A3

BIENNIAL AUDIT PLAN, UNIVERSAL SERVICE FUND – LIFELINE PROGRAM, APPENDIX A, TABLE 2
Direct Contact Re-certification
State Administrator/Eligibility Data Re-certification
Subscriber de-
enrolled prior to
Subscriber
Subscriber found
state
Subscriber
Subscriber
Subscriber de-
eligibility reviewed ineligible through administrator re-
Subscriber
responded to
responded to
enrolled prior to
by state
review by state
certification
contacted directly direct contact to direct contact that direct contact to
administrator or
administrator or
attempt or
Line provided to
to re-certify
re-certify
he/she is no
re-certify
via access to
via access to
eligibility data
wireline reseller?
eligibility?
eligibility?
longer eligible?
eligibility?
eligibility data?
eligibility data?
review?
Physical/
[Y/N]
[Y/N]
[Y/N/NA]
[Y/N/NA]
[Y/N/NA]
[Y/N]
[Y/N/NA]
[Y/N/NA]
Service Apt, Unit,
Telephon
(Form 555
(Form 555
(Form 555
(Form 555
(Form 555
(Form 555
(Form 555
(Form 555
Last Name First Name Address
or Lot #
City
State
Zip
e Number
Column B)
Column C)
Column D)
Column F)
Column H)
Column I)
Column J)
Column L)

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