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DOC-324275A3

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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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