**FCC Form 470** Approval by OMB

3060-0806

## Schools and Libraries Universal Service

**Description of Services Requested and Certification Form**

Estimated Average Burden Hours Per Response: 4 hours

**Instructions for Completing the**

**Schools and Libraries Universal Service**

**Description of Services Requested and Certification Form (FCC Form
470)**

**CONTENTS**

**Notice page 1**

I.  **Introduction page 2**

II. **Filing Requirements and General Instructions page 3**

III. **Minimum Processing Standards and Filing Requirement page 6**

IV. **Specific Instructions page 7**

V.  **Reminders page 18**

### NOTICE

Section 54.504 of the Federal Communications Commission\'s rules
requires all schools and libraries requesting universal service
discounts to file---individually, or as a district or system, or as a
consortium---this Description of Services Requested and Certification
Form (FCC Form 470) with the Universal Service Administrator, which is
the Schools and Libraries Division (SLD) of the Universal Service
Administrative Company (USAC). 47 C.F.R. § 54.504. For purposes of this
form, the universal service administrator will be referred to as the
"SLD" or "Fund Administrator." The collection of information stems from
the Commission\'s authority under Section 254 of the Communications Act
of 1934, as amended, 47 U.S.C. § 254. The data collected in Form 470
will be used to ensure that schools and libraries and any consortia they
comprise comply with the competitive bidding requirement contained in 47
C.F.R. § 54.504.

The FCC is authorized under the Communications Act of 1934, as amended,
to collect the information we request in this form. We will use the
information you provide to determine whether approving this application
is in the public interest. If we believe there may be a violation or
potential violation of any statute, regulation, rule or order, your
application may be referred to the Federal, state, or local agency
responsible for investigating, prosecuting, enforcing or implementing
the statute, rule, regulation or order. In certain cases, the
information in your application may be disclosed to the Department of
Justice or a court or adjudicative body when (a) the FCC; or (b) any
employee of the FCC; or (c) the United States Government is a party of a
proceeding before the body or has an interest in the proceeding.

If you owe a past due debt to the Federal government, the information
you provide may also be disclosed to the Department of the Treasury
Financial Management Service, other Federal agencies and/or your
employer to offset your salary, IRS tax refund or other payments to
collect that debt. The FCC may also provide this information to these
agencies through the matching of computer records when authorized.

If you do not provide the information requested on this form, the
processing of your application may be delayed or your application may be
returned to you without action.

The foregoing Notice is required by the Paperwork Reduction Act of 1995,
Pub. L. No. 104-13, 44 U.S.C. § 3501, *et seq*. An agency may not
conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB
control number.

Public reporting burden for this collection of information is estimated
to average four hours per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining
the data needed, completing, and reviewing the collection of
information. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for
reducing the reporting burden, to the Federal Communications Commission,
Performance Evaluation and Records Management Branch, Washington, DC
20554.

## I. INTRODUCTION

-   The purpose of the FCC Form 470 is to open a competitive bidding
    process for the services desired.

-   An applicant cannot seek discounts for services in a category of
    service on the Form 471 if those services in those categories were
    not indicated on a Form 470.

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-   The Form 470 MUST be completed by the entity that will negotiate
    with potential service providers.

-   The Form 470 cannot be completed by a service provider who will
    participate in the competitive process as a bidder. If a service
    provider is involved in preparing the Form 470 and that service
    provider appears on the associated Form 471, this will taint the
    competitive process and lead to denial of funding requests that rely
    on that Form 470.

-   The Form 470 applicant is responsible for ensuring an open, fair
    competitive process and selecting the most cost-effective provider
    of the desired services.

-   Applicants should save all competing bids for services to be able to
    demonstrate that the bid they chose is the most cost-effective, with
    price being the primary consideration.

On May 7, 1997, the Commission adopted rules providing discounts on
eligible telecommunications services, Internet access, and internal
connections, for eligible schools and libraries. To initiate the
required competitive bidding process, begin by filing this form with the
Schools and Libraries Division (SLD). The SLD will post this information
on the SLD's web site for at least 28 days to fulfill the competitive
bidding requirement. Contracts for newly contracted services or the
selection of service providers for tariffed or month-to-month services
cannot occur earlier than 28 days after the descriptions set forth in
the relevant Form 470 posted on the SLD web site \<
www.sl.universalservice.org\>. The SLD will notify the applicant of the
date that the applicant's request is posted and the date on which the
28-day waiting period ends. Those with questions about this form may
call the SLD's Client Service Bureau toll-free at\
1-888-203-8100.

**II. FILING REQUIREMENTS AND GENERAL INSTRUCTIONS**

**A. Who Must File**

Schools and libraries requesting universal service discounts must seek
competitive bids using Form 470. The entity that will negotiate with
potential service providers should complete Form 470. The Form 470
cannot be completed by a service provider who will participate in the
competitive process as a bidder.

For purposes of the universal service support mechanism, schools must
meet the statutory definition of elementary and secondary schools found
in the Elementary and Secondary Education Act of 1965, as amended, 20
U.S.C. § 8801(14) and (26). An elementary school is a non-profit
institutional day or residential school, including a public elementary
charter school, that provides elementary education, as determined under
state law. 47 C.F.R. § 54.500(b) and 20 U.S.C. § 8801(14). A secondary
school is a non-profit institutional day or residential school,
including a public secondary charter school, that provides secondary
education, as determined under state law, except that such term does not
include any education beyond grade 12. 47 C.F.R. § 54.500(j) and 20
U.S.C. § 8801(26). Schools operating as for-profit businesses or who
have endowments exceeding \$50 million are not eligible. 47 C.F.R. §
54.501(b)(2) and (b)(3).

Libraries must meet the statutory definition of library or library
consortium found in the Library Services and Technology Act, Pub. L. No.
104-208, sec. 211 *et seq.*, 110 Stat. 3009 (1996) (LSTA) and must be
eligible for assistance from a state library administrative agency under
that Act. A library includes: \"(1) a public library; (2) a public
elementary school or secondary school library; (3) an academic library;
(4) a research library, which for the purposes of this definition means
a library that: (i) makes publicly available library services and
material suitable for scholarly research and not otherwise available to
the public; and (ii) is not an integral part of an institution of higher
education; and (5) a private library, but only if the state in which
such private library is located determines that the library should be
considered a library for purposes of this definition.\" 47 C.F.R. §
54.500(c). A library\'s eligibility for universal service funding also
depends on its funding as an independent entity. **Only libraries whose
budgets are completely separate from any schools (including, but not
limited to, elementary and secondary schools, colleges and universities)
shall be eligible to receive discounted services** under the universal
service support mechanism. 47 C.F.R. § 54.501(c)(2). For example, an
elementary school library would only be eligible to receive discounted
services if its budget were completely separate from the elementary
school. If its budget were not completely separate from the elementary
school, the elementary school library would not be eligible for support
independent from the school with which it is associated.

A library consortium is \"any local, statewide, regional, or interstate
cooperative association of libraries that provides for the systematic
and effective coordination of the resources of school, public, academic,
and special libraries and information centers, for improving services to
the clientele of such libraries.\" 47 C.F.R. § 54.500(d).

Libraries operating as for-profit business shall not be eligible for
discounts. 47 C.F.R. § 54.501(c)(3).

**B. When, Where, and How Many Forms 470 to File**

Beginning with the application process for Funding Year 2000 (July 1,
2000 through June 30, 2001), you are required to file Form 470 in the
current application period only if you are applying for discounts for
one of the following types of services:

-   tariffed services (telecommunications services purchased at
    regulated rates) for which you do not have a signed, written
    contract (a Form 470 must be filed for these services each year);

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-   month-to-month Internet access, cellular services, or paging
    services for which you do not have a written contract but for which
    your standard monthly bills are proof of a binding, legal
    arrangement (a Form 470 must be filed for these services each year);

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-   any services for which you seek a new contract; or

-   any multi-year contract signed on or before July 10, 1997, but for
    which you have not before filed a Form 470 in any previous program
    year.

Notice will be posted each year on the SLD web site
\<www.sl.universalservice.org\> when we will begin accepting Forms 470
for posting. This notice will be posted at least 12 months before the
start of the appropriate funding year. The precise timeframe for filing
Form 470 depends on the kind of service you are seeking:

-   For tariffed telecommunications services or month-to-month services,
    Form 470 must be filed at least 28 days before you file Form 471.

-   For contract services for which you are seeking a new contract for
    the coming funding year, you may file Form 470 after the SLD posts
    the above notice whenever you wish to begin your procurement
    process, as long as it is at least 28 days before you file Form 471.

-   For a contract signed on or before July 10, 1997, for which no Form
    470 has ever been filed, you must file a Form 470 at least 28 days
    before you file Form 471.

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-   For multi-year contracts signed pursuant to the posting of a Form
    470 in a previous funding year, you will not need to file a new Form
    470 for the upcoming funding year. Your 28 days began with the date
    of your original Form 470 posting.

Services that are covered by a **qualified existing contract** for all
or part of the funding year do not require filing of Form 470, since you
are not seeking bids for these services. A qualified existing contract
is:

-   a signed, written contract executed pursuant to the posting of a
    Form 470 in a previous funding year, OR

-   a contract signed on or before July 10, 1997 and reported on a Form
    470 in a previous year as an existing contract.

If you are seeking support for eligible services not covered by a
qualified, existing contract, you must file Form 470 **either
electronically at the SLD web site, \<www.sl.universalservice.org\>, or
at the address listed at the bottom of the form (SLD-Form 470, P.O. Box
7026, Lawrence, Kansas 66046-7026).** For express delivery or U.S.
Postal Service Return Receipt Requested, send to: **SLD-Form 470, c/o
Ms. Smith, 3833 Greenway Drive, Lawrence, Kansas 66046**, phone (888)
203-8100. DO NOT FILE THIS OR ANY OTHER UNIVERSAL SERVICE FORM WITH THE
FEDERAL COMMUNICATIONS COMMISSION.

You may file one Form 470 for all of the services for which you are
required to file Form 470, or you may file separate Forms 470 for each
type of service. Also, an individual school or library may be covered by
more than one Form 470 filed by different consortia for different
services.

Once you file your Form 470, it is posted to the SLD web site for
competitive bidding. Your form must be posted for at least 28 days on
the SLD web site before you can sign a contract or enter into an
agreement for services. After you sign a contract or enter into an
agreement, you (or the billed entities you represent) can initiate the
next step in the application process, the filing of FCC Form 471. Upon
processing or posting of the Form 470, the SLD will notify you of the
date upon which you may sign a contract or enter into an agreement for
new services or file Form 471. 47 C.F.R. §54.504(b)(4). This date will
be referred to as the "Allowable Vendor Selection/Contract Date."

#  Assistance in Completing This Form

There are several sources of assistance to guide you in completing this
form. If you complete this form electronically on the SLD web site
**\<www.sl.universalservice.org\>,** prompts may occur to assist you as
you enter information. Whether you file electronically or on paper, you
are also urged to consult the Reference Area of the SLD web site,
**\<www.sl.universalservice.org\>,** for additional program guidance
that may be useful in completing this form. **.** Further information is
also available from the SLD Client Service Bureau via toll-free
telephone at\
**1-888-203-8100;** via e-mail at **question@universalservice.org;** or
via fax at **1-888-276-8736.**

**D. Compliance**

Schools and libraries filing false information are subject to penalties
for false statements under Title 18 of the United States Code, 18 U.S.C.
§ 1001. Applicants should retain the worksheets and other records they
use to compile these forms for five years. Thus, if applicants represent
multiple entities, collect data from those entities, and add up that
data, they should retain those data sheets for five years. If an
applicant is audited, it should be prepared to make the worksheets and
other records used to compile these forms available to the auditor
and/or the Administrator, and it should be able to demonstrate to the
auditor and/or Administrator how the entries in its application were
provided.

**III. MINIMUM PROCESSING STANDARDS AND FILING REQUIREMENT**

**Form 470 Minimum Processing Standards**

When a Form 470 is received by the SLD, the form is first reviewed to
make sure it complies with the following requirements before data entry
begins. These minimum processing requirements are necessary in order to
ensure the timely and efficient processing of properly completed
applications. If a Form 470 fails to meet these requirements, the Form
470 will be rejected. The SLD may be prevented from returning the
rejected Form 470 to the sender if the form lacks essential identifying
information. If an applicant receives a returned Form 470, it is
important that it resubmit the corrected form quickly. Once the
corrected form is successfully data entered, the form will be posted to
the SLD web site. The posting of the form to the SLD web site marks the
beginning of the required 28-day waiting period.

**Manual Filers**

**1. Correct Form:** Each Form 470 must be:

-   the correct, OMB-approved FCC Form 470, with a date of September
    1999 or later in the lower right hand corner;

-   submitted by regular mail, express delivery, or U.S. Postal Service
    Return Receipt Requested, or hand delivery. Forms may not be
    submitted by fax or e-mail. You are advised to keep proof of the
    date of mailing.

**2. Applicant Address and Identifications:** In Block 1, each of the
following items must be properly completed:

-   Item (1) or (3) Either the Name of the Applicant or the Entity
    Number;

-   Item (2) Funding Year

-   Item (6a) Contact Person Name

> If any of these items is blank, and the information cannot be obtained
> from the page headers, the Form 470 will be rejected.

**3. Complete Submission of Form 470:** All 5 blocks of the Form 470
must be submitted. If any Block (1-5) is missing, the form will be
rejected.

**4. Valid Certification:** Block 5, Item (25) Signature of authorized
person must be completed. If Item (25) is left blank, the Form 470 will
be rejected.

**Online Filers:**

When Blocks 1-4 of a Form 470 are submitted electronically, the
applicant must also (1) submit the completed Block 5 certification
online with a User ID and a PIN or (2) submit the completed and signed
Block 5 certification manually by mail, express delivery or U.S. Postal
Service Return Receipt Requested. If the Block 5 certification is
submitted manually, you are advised to keep proof of the date of
mailing. The Block 5 certification is reviewed to make sure it complies
with the requirements listed in #4 above. Reviewers also look for the
Form 470 Application Number before the Certification and Signature Page
is accepted and the Form 470 reaches "certified" status. If the Block 5
certification document lacks the information necessary to match your
manually submitted certification with the electronically filed Blocks
1-4 of the form, then your application will not meet the application
filing requirements.

**Filing Requirement for Forms 470 Submitted Manually and Online**

It is vital to assure that a completed Form 470 Certification is filed
in a timely fashion. A completed Form 470 Certification is a Block 5
certification submitted online using a User ID and a PIN or a Block 5
certification with the signature of the authorized person. Forms 470
with completed certifications submitted in a previous year meet this
requirement, as do those filed for the current funding year either
online by the close of the Form 471 application filing window or with a
postmark date no later than the close of the Form 471 application filing
window. Any Form 471 Block 5 funding request based on a Form 470 whose
certification has not been received or postmarked by 11:59 p.m. EST on
the close of the Form 471 application filing window will be rejected.

## IV. SPECIFIC INSTRUCTIONS

You are encouraged to complete, submit, and certify this Form
electronically at \<www.sl.universalservice.org\>. If you file manually,
the Form 470 can be downloaded from the SLD web site. If you file paper
copies of the application, please type or clearly print in the spaces
provided and attach additional pages if necessary and when required.
Instructions for completing each Block and Item of the Form 470 can also
be downloaded from the SLD web site. No Forms 470 will be accepted if
sent via e-mail or fax.

**A. Top of Form**

The data at the top of Form 470 will help both you and the SLD identify
each particular Form 470 you file.

**"Do Not Write In This Area"---**The SLD uses this space to apply a
barcode to your form upon receipt, so that we can properly track and
archive your form.

**Applicant's Form Identifier---**If you are filing more than one Form
470, please use this space to assign a unique number or letter of your
own devising to facilitate communication with us about THIS particular
Form 470. This Applicant's Form Identifier can be very simple; for
example, if you are filing three Forms 470, you might label them "A,"
"B," and "C." The Applicant's Form Identifier can also be descriptive,
such as "School Internet." Choose identifiers that suit your own
record-keeping needs.

**Form 470 Application Number---**The SLD will assign and insert your
Form 470 Application Number. Leave this item blank.

**Top of each page after page 1:** If you are filing this application
manually, to help alleviate problems caused if the pages of an
application become separated, please provide the Entity Number (from
Item 3, below), your Applicant's Form Identifier, and name and phone
number of the contact person (from Item 6, below) at the top of each
page of the application in the space provided. If you are filing
electronically, this information will automatically appear at the top of
each page.

**B. Block 1: Applicant Address and Identifications**

Block 1 of Form 470 asks you for your address and basic identifications.
Throughout this form, \"you\" refers to "the applicant" -- a school or
library, or an entity filing on behalf of schools and libraries. The
Form 470 cannot be completed by a service provider who will participate
in the competitive process as a bidder.

**Item (1) --** Provide the name of the Applicant. You may be an
individual school, a school district, a library (outlet/branch, system)
or a consortium of those entities. You may also be a city, a state, or
an entity created solely to participate in this universal service
discount mechanism.

**Item (2) --** Funding years begin on July 1 and end on June 30 each
year. For example, Funding Year 2003 runs from July 1, 2003 to June 30,
2004. Provide the funding year for which you are applying for funds by
filling in the appropriate year in the blanks provided (e.g., July 1,
[2003]{.underline} through June 30, [2004]{.underline}).

**Item (3)** **--** Your Entity Number is a unique number assigned to
your organization or institution by the SLD as a means of identifying
you every time you file an application or otherwise communicate with us.
If you have applied for universal service funds in previous years, or
have been identified in an application filed on your behalf, you have
already been assigned an Entity Number. If you do not have a record of
your Entity Number, or if you have never been assigned such a number,
please call the SLD Client Service Bureau at 1-888-203-8100.

**Item (4)(a)-(4)(d) --** Provide your full mailing address, whether a
street address, Post Office Box number, or route number. You are
strongly encouraged to provide a street address rather than a Post
Office Box if possible, as the Fund Administrator may need to contact
you via overnight or express delivery. In addition, please provide your
telephone number (with area code and extension), fax number (including
area code), and e-mail address (if you have one).

**Item (5) --** Check the one box that best describes the type of
application you are filing. If you are filing as a library
(outlet/branch, system, or library consortium applying as a library),
you should check the first box. If you are filing as an individual
school, you should check the second box. If you are filing as a school
district, you should check the third box. If you are filing as a
consortium, you should check the fourth box. (You may be a consortium of
schools, libraries, or some combination of the above which may or may
not include ineligible entities.)

**Item (6)(a) --** Provide the name of the person who should be
contacted with questions about this application. This person should be
able to answer questions regarding the information included on this form
and the services you request, including how to obtain a copy of your
request for proposal (RFP), if you have prepared one.

**Item (6)(b)-(6)(e) --** If the contact person's address, phone number,
fax number, or e-mail address is different from those specified for the
applicant (completed in Item (4)), please provide that information here.
You MUST then check the preferred mode of contact. Wherever possible,
the SLD will use this mode to contact you.

## Block 2: Summary Description of Needs or Services Requested

Block 2 of Form 470 asks you to describe the services you desire.

**Item (7)** **--** Specify here the kind(s) of services requested in
this Form 470. You may check one or more of these choices, depending on
the range of services you will be including on one Form 470.

**Item (7)(a) --** Check this box if this Form 470 requests services
which are tariffed (telecommunications services for which you do not
have a signed, written contract). These services require posting of a
Form 470 for each funding year.

**Item (7)(b) --** Check this box if this Form 470 requests Internet
access, cellular service, or paging services provided on a
month-to-month basis without a written contract. These services require
posting of a Form 470 for each funding year.

**Item (7)(c) --** Check this box if this Form 470 seeks new services
for which you wish to sign a new contract. You may file a Form 470 for a
new contract after notice is posted on the SLD web site that the SLD
will begin accepting Forms 470 for the appropriate funding year for
posting.

**Item (7)(d) --** Check this box if this Form 470 describes services
provided under a multi-year contract that was signed on or before July
10, 1997 but that was never featured on a Form 470 in previous program
years. For example, if you are applying for the E-rate for the very
first time for Funding Year 2003 (07/01/2003--06/30/2004), and some or
all of your services are provided under a written 10-year contract which
was signed on July 1, 1997, you will need to file a Form 470 for this
contract. In future years, for as long as that contract remains in
force, you will not need to file a Form 470 for those services. There is
no required timeframe for filing a Form 470 for this purpose, but your
form must be posted for at least 28 days on the SLD web site before you
can file a Form 471 online.

**Items (8)-(10) --** One or more of Items (8)-(10) must be completed to
provide potential bidders with particular information about the services
you are seeking. For more information on eligible services, please refer
to the Eligible Services List on the SLD web site
\<www.sl.universalservice.org\> or call the SLD Client Service Bureau
toll-free at\
1-888-203-8100. Once you check the relevant category of service box(es)
in Items (8), (9), and/or (10), you must check either box (a) or (b)
under the selected item and complete the item. You cannot seek discounts
on services in a category of service on the Form 471 if you have not
competitively bid those services in the same category of service on the
Form 470.

The specific data requested in Items (8)-(10) are sought to provide
potential service providers with information so that they may contact
you if necessary for detailed information on your specific requirements.
**This requirement is not intended to restrict your ability to contract
for newly contracted services or enter into agreements for tariffed or
month-to-month services for whatever technologies best meet your
educational purposes as authorized by FCC rules and the
Telecommunications Act of 1996.** It is important that you complete all
categories that are relevant to your requested services, so that the
Fund Administrator can confirm that you have met the competitive bidding
requirement before signing any contracts for newly contracted services
or entering into agreements for tariffed or month-to-month services for
which discounts are requested in FCC Form 471.

**Item (8)** **--** Check this box if you are seeking telecommunications
services to be provided by one or more telecommunications services
providers. **Important note: Only telecommunications services requested
from telecommunications companies who provide their telecommunications
services on a common carriage basis (meaning they provide their services
for a fee to the general public) will be eligible for discount(s) under
the universal service support mechanism.** **If you request
telecommunications services from a telecommunications provider that does
not provide telecommunications services on a common carriage basis, your
Form 471 Funding Request for such services will be denied*.***
Telecommunications is "the transmission, between or among points
specified by the user, of information of the user's choosing, without
change in the form or content of the information as sent and received."
47 U.S.C. § 153(43) and 47 C.F.R. § 54.5. All commercially available
telecommunications services, including charges such as state and federal
taxes, are eligible for support under the universal service discount
mechanism. For example, local and long distance telephone services are
generally considered telecommunications services. As another example,
high-speed transmission lines over the public switched
telecommunications network leased from an eligible telecommunications
provider would be listed here as a telecommunications service. See the
Eligible Services List on the SLD web site
\<www.sl.universalservice.org\> for more information.

**Item (8)(a) --** Check this box if you have a Request for Proposal
(RFP) that will provide potential bidders with specific information
about the particular telecommunications services or functions you are
seeking, and what quantity and/or capacity you seek. For example, you
might have an RFP for voice services that specifies "local and long
distance voice services sought for 20 existing phone lines, plus 10 new
additional lines." If you check (8)(a), you must indicate where this RFP
is available, such as on your web site (list the web address); via the
Contact Person listed in Item (6); and/or via the alternative contact
person listed in Item (11). If the RFP is not posted on a web site, your
designated contact person must be able to provide it to service
providers on request as of the date that your Form 470 is posted.

**Item (8)(b) --** Check this box if you do NOT have a Request for
Proposal (RFP) for the telecommunications services you seek. If you
check (8)(b), you must fill in details in the space provided about the
specific telecommunications services or functions and quantity and/or
capacity of service. For example, you might list "videoconferencing
services" under Service or Function, and "for three school buildings"
under Quantity and/or Capacity.

**Item (9) --** Check this box if you are seeking Internet access
services. Basic conduit non-content access to the Internet is eligible
for support under the universal service discount program. See the
Eligible Services List on the SLD web site
\<www.sl.universalservice.org\> for more information.

Please note that while schools and libraries may obtain universal
service discounts on access to the Internet, discounts are not available
on the separate charges for particular proprietary content or other
information services or on a bundled package of access and content,
unless the bundled package includes minimal content and provides a more
cost-effective means of securing access to the Internet than other
non-content alternatives.

**Item (9)(a) --** Check this box if you have a Request for Proposal
(RFP) that will provide potential bidders with specific information
about the particular Internet access services or functions you are
seeking, and what quantity and/or capacity you seek. For example, you
might have an RFP for Internet access that specifies "high-speed direct
access to the Internet sought for 10 public Internet stations in one
library facility." If you check (9)(a), you must indicate where this RFP
is available, such as on your web site (list the web address); via the
contact person listed in Item (6); and/or via the alternative contact
person listed in Item (11). If the RFP is not posted on a web site, your
designated contact person must be able to provide it to service
providers on request as of the date that your Form 470 is posted.

**Item (9)(b)** **--** Check this box if you do NOT have a Request for
Proposal (RFP) for the Internet access services you seek. If you check
(9)(b), you must fill in details in the space provided about the
specific Internet access services or functions and quantity and/or
capacity of service. For example, you might list "monthly Internet
service" under Service or Function, and "for 500 student users" under
Quantity and/or Capacity.

**Item (10)** **--** Check this box if you are seeking internal
connections services. A given service is generally eligible for support
under the universal service discount mechanism as a component of
internal connections if it "is necessary to transport information within
one or more instructional buildings of a single school campus or within
one or more non-administrative buildings that comprise a single library
branch." 47 C.F.R. § 54.506. See the Eligible Services List on the SLD
web site \<www.sl.universalservice.org\> for more information.

**Item (10)(a) --** Check this box if you have a Request for Proposal
(RFP) that will provide potential bidders with specific information
about the particular internal connections services or functions you are
seeking, and what quantity and/or capacity you seek. For example, you
might have an RFP for internal connections that specifies "local area
network to connect 30 classrooms." If you check (10)(a), you must
indicate where the RFP is available, such as on your web site (list the
web address); via the contact person listed in Item (6); and/or via the
alternative contact person listed in Item (11). If the RFP is not posted
on a web site, your designated contact person must be able to provide it
to service providers on request as of the date that your Form 470 is
posted.

**Item (10)(b) --** Check this box if you do NOT have a Request for
Proposal (RFP) for the internal connections services you seek. If you
check (10)(b), you must fill in details in the space provided about the
specific internal connections services or functions and quantity and/or
capacity of service. For example, you might list "Private Branch
Exchange equipment" under Service or Function, and "for each of 10
outlets in library system" under Quantity and/or Capacity.

**Item (11) --** (Optional) Provide the name and contact information of
the person on your staff or project who can provide additional technical
details or answer specific questions from service providers about the
services you are seeking. This need not be the contact person listed in
Item (6) nor the authorized person identified in Item (27).

**Item (12)** **--** Indicate whether you are subject to any state or
local restrictions regarding how and when you may be contacted by
potential providers and what bidding procedures they must follow. For
example, state bidding requirements might prohibit contacts between
bidders and buyers between the time an official RFP is issued and when
bids are due, or they may allow only written contacts. [Applicants must
also comply with any applicable state or local requirements when
participating in the competitive bidding process used in the universal
service discount mechanism.]{.underline} If you are subject to any state
or local restrictions, you must check the box in Item (12) and provide a
description of the restrictions or procedures. Alternatively, you may
list a web site address where state or local restrictions can be found
and the name and telephone number for a contact person who can provide
the state or local restrictions and the applicable bidding procedures to
service providers without Internet access.

**Item (13) --** You may provide information on your plans to purchase
additional services in future years if you wish to encourage service
providers to contact you even when you may not represent a financially
attractive customer in the near term, but you may represent a
financially attractive customer over a longer period of time. Providing
this information is optional.

> **D. Block 3: Technology Assessment**

Block 3 of Form 470 asks you to provide an assessment of the resources
that you will need to use the services you request by checking off the
appropriate boxes, unless you are seeking support for basic local and/or
long distance telephone service (wireline or wireless) only.

**Item (14) --** Check this item if you are seeking support for basic
local and/or long distance telephone service (wireline or wireless)
only. If you check Item (14), you should skip Item (15) and go to Item
(16).

**Items (15)(a)-(15)(e) --** All of the services and facilities listed
in Items (15)(a)-(15)(e) are ineligible for support under the universal
service discount mechanism. Each of the services and facilities listed,
however, is necessary to make effective use of the telecommunications
services, Internet access, and internal connections that are eligible
for discounts. You do not need to certify that you have already secured
all of the resources needed to use your discounted services effectively
until you file FCC Form 471, but Items (15)(a)-(15)(e) require you to
assess the technologies that you have or will need. You must check off
at least one box for each of the Items (15)(a)-(15)(e). You may check
off both boxes in each case if both apply. When you file Form 471, which
is required to receive discounts, you will need to certify that you have
secured or budgeted to secure adequate amounts of those resources to
utilize effectively the services requested.

If you are seeking to purchase any of the ineligible services or
facilities indicated in Items (15)(a)-(15)(e), you may also provide
additional details in Item (15)(f) if you wish to have providers of
these desired technologies or services contact you with bids. **If you
are purchasing such ineligible services and facilities, however, you
should try to do so through contracts separate and apart from those used
to purchase services eligible for universal service discounts, to avoid
confusion when completing and submitting your Form 471 application for
services ordered.**

**Item (15)(a) --** Indicate whether you have secured or are in the
process of securing access to the necessary software for the desktop
computers that will use eligible services. For example, computers that
will be connected to the Internet will probably need Web browsers. You
should note that, although the software for the computers used in
classrooms and other endpoints is not eligible for support, the software
necessary to operate the networks used to transport information to the
classroom is an eligible service.

**Item (15)(b) --** Confirm that you have or are in the process of
securing access to sufficient electrical capacity to handle the
computers and other telecommunications-related facilities you will be
using to access the discounted services.

**Item (15)(c) --** Confirm that you have purchased or are arranging to
purchase sufficient numbers of computers to use the discounted services
effectively. Applicants should note that, as with computer software,
while the computers used in classrooms are not eligible for discounts,
those used as network file servers would, generally, be eligible for
support.

**Item (15)(d) --** Confirm that you have secured or are in the process
of securing appropriate maintenance for your computer hardware that will
use eligible services.

**Item (15)(e) --** Confirm that you have arranged for or are arranging
to secure the staff development necessary to use the discounted services
effectively.

**Item (15)(f) --** Use this space to provide additional details to help
providers identify the services you desire. Providing this information
is optional.

# E. Block 4: Recipients of Service

Block 4 requires you to provide information about the entities that will
receive the services described in Block 2. This information is required
to help service providers understand the scope and location(s) of the
services you seek, so that they may respond efficiently and effectively.

**Item (16) --** Check the one choice -- (a), (b), or (c) -- that most
accurately describes your application and the eligible entities that
will receive the services you are seeking in this Form 470, then provide
additional information only for the choice you have selected. An entity
is an eligible entity if it meets the eligibility criteria for obtaining
discounts described in Section II.A. above.

**Item (16)(a) --** Check this Item if you are an individual school or a
single-site library located at the address in Item (1). Checking this
box will confirm for potential bidders that all the services you seek
will be delivered to this address.

**Item (16)(b) --**Check this Item if yours is a statewide application
representing ALL entities of a particular type in your state. If you
check Item (16)(b), you must also check one or more of the three choices
provided in this item: all public schools/districts in the state, all
non-public schools in the state, and/or all libraries in the state. This
will indicate to potential service providers the complete breadth of
your service needs. Please note that if your application represents SOME
but not ALL of any of these three types of entities, you should NOT
check Item (16)(b), but must check and complete Item (16)(c) instead.
Indicate by checking "yes" or "no" whether your application includes
requests for services for any ineligible entities.

**Item (16)(c) --** Check this Item if you are a school district,
library system, or consortium serving multiple entities. If you check
Item (16)(c), you must specify the number of eligible entities that your
application represents. You must then list each unique area code
represented in the telephone numbers of the entities you represent, plus
the three-digit prefixes (the first three digits of the phone number)
associated with each area code among the entities you represent. For
example, if your school district is in a state which has one statewide
area code, you would list that area code once. You would then list each
unique three-digit prefix represented among the telephone numbers of the
schools and administrative buildings in your district which will receive
the service(s) requested in this Form 470. This information helps
service providers pinpoint the location of each facility that will be
receiving service. Indicate by checking "yes" or "no" whether your
application includes requests for services for any ineligible entities.

**Item (17)** **--** List here the entity or entities that will be
paying bills directly to the service provider for the services requested
in this application. Such entities are known as "billed entities," and
are the entities who file Form 471. List these billed entities, whether
or not they themselves are eligible for universal service discounts, and
provide their Entity Numbers. For example, if you are a consortium of
school districts joining together to aggregate demand and thus secure a
better price on telecommunications services that each district will then
contract for and pay for individually, you will list your member
districts and their Entity Numbers in Item (17). As another example, if
you are a library whose bills are paid by the municipal government, you
should list the municipal government office and its Entity Number. List
each entity's name in the left column, and its Entity Number in the
right column. If, however, your application is statewide as indicated in
Item (16)(b), then enter only one billed entity from your state. If you
need help identifying Entity Numbers for each of these "billed
entities," call the SLD Client Service Bureau at 1-888-203-8100.

**Item (18) --** List the names of any entities for whom services are
requested that are not eligible to receive universal service discounts
under the schools and libraries universal service support mechanism.
Only eligible schools and libraries may receive discounted services, so
if this application includes services for entities such as health care
providers, governmental entities, or private sector entities, you must
list these entities in Item (18). Skip this item if your application
requests services only for eligible entities. For each ineligible
entity, provide the area code and three-digit prefix to help service
providers pinpoint the entity's location. If your application is
statewide, as indicated in Item (16)(b), only one area code and prefix
for each named ineligible entity is required.

> **F. Block 5: Certifications and Signature**

Block 5 requires you to certify certain information to ensure that only
eligible entities receive support under the universal service discount
mechanism.

**Item (19) --** Certify that the entities in Item (16) are eligible
schools and/or libraries.

**Item (19)(a)** **--** If your application includes schools and all of
the information in Item (19)(a) is true of those schools seeking to
receive discounted services, you should check the box in Item (19)(a).
If your application includes schools and any of the information in Item
(19)(a) is not true for certain schools seeking to receive discounted
services, those ineligible schools are not eligible to receive support
under the universal service discount mechanism, and they must be
identified in Item 18.

**Item (19)(b)** **--** If your application includes libraries or
library consortia and all of the information in Item (19)(b) is true of
the libraries seeking to receive discounted services, you should check
the box in Item (19)(b). If your application includes libraries or
library consortia and any of the information is not true for certain
libraries or library consortia seeking to receive discounted services,
those ineligible libraries or library consortia are not eligible to
receive support under the universal service discount mechanism, and they
must be identified in Item 18.

**Items (20) and (21)** concern the technology plans that must be
prepared before schools and libraries may receive discounted services
under the universal service support mechanism. The only schools and
libraries that do not have to comply with the technology plan
requirement are those requesting support for basic local and/or long
distance telephone service (wireline or wireless) only. Note also that
consortia and some other billed entities do not have to be covered by
technology plans as long as all of the schools and libraries that they
represent are covered by technology plans.

**Item (20)** **--** Check the box that best describes the level of
technology plan(s) that covers the schools, libraries, and library
consortia represented by your application.

-   **Item (20)(a) --** Check here if the entities are covered by
    [individual]{.underline} technology plans for the services requested
    in your application.

-   **Item (20)(b) --** Check here if the entities are covered by a
    [higher-level, multi-entity]{.underline} technology plan, such as a
    school district or library system plan. Statewide technology plans
    are not acceptable.

-   **Item (20)(c) --** Check here if your application is for basic
    local and/or long distance telephone service (wireline or wireless)
    only, in which case no technology plan is required.

**Item (21) --** Check the box that best describes the status of the
technology plan(s):

-   **Item (21)(a) --** Check here if your plans have been approved.
    NOTE: Technology plans that have been approved for other purposes,
    e.g., for participation in Federal or state programs such as the
    "Enhancing Education through Technology" program, will be accepted
    without need for further independent approval.

-   **Item (21)(b)** **--** Check here if you are currently seeking
    approval of your technology plan(s). Please note that the SLD does
    not review technology plans itself, but does certify authorized
    reviewers of technology plans. If you need assistance identifying a
    certified approver for your technology plan, please call the SLD
    Client Service Bureau at 1-888-203-8100.

-   **Item (21)(c)** **--** Check here if your application is for basic
    local and/or long distance telephone service (wireline or wireless)
    only, in which case no technology plan is required.

**Item (22) --** Certify that services you order pursuant to the
universal service discount mechanism will be used solely for educational
purposes and that those services will not be sold, resold, or
transferred in consideration for money or any other thing of value.

**Item (23) --** Certify that you recognize that any support received
under this support mechanism is conditional upon the ability of your
school(s) or library(ies) to secure access to all of the resources,
including computers, training, software, maintenance, and electrical
connections, necessary to use effectively the services that will be
purchased under this mechanism. On FCC Form 471, you will need to
certify that you have access to such funding.

**Item (24)** **--** Certify that you are the person authorized to
submit and certify to the accuracy of this form.

**Item (25)** requires the signature of the authorized person.

**Item (26)** requires that the date of the signature of the Form 470 be
provided**.**

**Item (27)** **--** Print the name of the authorized person whose
signature is provided in Item 25.

**Item (28)** **--** Provide the title or position of the authorized
person whose signature is provided in Item (25).

**Item (29)** **--** Provide the telephone number, including area code,
of the authorized person whose signature is provided in Item (25).

**For Applicants Filing this Form Electronically:**

-   When you have completed the electronic filing of Blocks 1-4, please
    print your application to retain a copy for your records.

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-   You must also submit the Block 5 certification.

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-   If you have a User ID and PIN and wish to electronically submit your
    Block 5 certification, follow the directions online. When you submit
    your certification online, you will receive a confirmation so that
    you can be assured that your submission has met any filing
    deadlines. If you file online and use electronic certification, do
    not mail any part of your Form 470 to the SLD. Check the SLD web
    site for information about obtaining a User ID and a PIN.

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-   If you wish to submit the completed and signed Block 5 certification
    manually, print Block 5 using your browser. When you print Block 5
    using the browser, the form will automatically include your Form 470
    Application Number, Applicant Name, and Applicant Address. Item (25)
    requires the signature of the authorized person who will certify to
    the accuracy of the information on the form. Also, you must complete
    Items (19)-(24). Mail the signed Block 5 to: **SLD-Form 470, P. O.
    Box 7026, Lawrence, Kansas 66044-7026.** For express delivery
    services or U.S. Postal Service Return Receipt Requested, send to
    **SLD-Form 470, c/o Ms. Smith, 3833 Greenway Drive, Lawrence, Kansas
    66046**. Note: Do not mail the complete Form 470. Mail only the
    signed Block 5 certification page. If the Block 5 certification is
    submitted manually, you are advised to keep proof of the date of
    mailing.

**For Applicants Filing this Form Manually:**

After the authorized person signs Item (25), check to be certain that
all other items---including Items (26)-(29)---are properly completed.
Make a copy of your entire form to keep for your records. Then submit
your original form by mail to: **SLD-Form 470, P.O. Box 7026, Lawrence,
Kansas 66044-7026.** For express delivery or U.S. Postal Service Return
Receipt, send to**: SLD-Form 470, c/o Ms. Smith, 3833 Greenway Drive,
Lawrence, Kansas 66046**, phone 1-888-203-8100. **No Forms 470 will be
accepted via e-mail or fax.**

**V. REMINDERS**

-   All schools and libraries seeking universal service support for ANY
    service not covered by a qualified existing contract (i.e., a
    contract executed pursuant to Form 470 posting in prior program
    years OR a contract signed on or before July 10, 1997 and identified
    as pre-existing in a Form 470 filed in prior years) must file Form
    470 individually or be included in a consortium that files Form 470.
    Services that must be represented in an individual or consortium
    Form 470 in order to qualify for universal service support include:
    eligible tariffed telecommunications services; month-to-month
    services provided without a signed, written contract; new services
    for which a contract is sought; or services provided under a
    multi-year contract signed on or before July 10, 1997, but not
    previously identified as an existing contract in a Form 470 filed in
    a prior program year.

-   A Form 470 is NOT required for services covered by a qualified
    existing contract (i.e., a contract executed pursuant to Form 470
    posting in a prior program year OR a contract signed on or before
    July 10, 1997 and identified as pre-existing in a Form 470 filed in
    prior years).

-   Fill out all applicable items completely. Attach additional pages if
    necessary. Any attachments to Form 470 should be clearly labeled
    with your Entity Number, Applicant's Form Identifier, Contact Person
    Name, and Phone Number.

-   If you have a Request for Proposal (RFP) for the services requested
    in this Form 470---and therefore have checked (a) under Items (8),
    (9), and/or (10)---your RFP must be available to service providers
    via a web site or your designated contact person in Item (6) or the
    contact listed in Item (11) as of the date that this Form 470 is
    posted on the SLD web site.

-   The individual authorized to order telecommunications and other
    supported services for the school, school district, library, or
    consortium must sign and date Form 470.

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-   If you are filing Form 470 electronically, you must also complete
    and submit the Block 5 certification (whether electronic or paper).