Applicant Forms

Form	#	Description
USAC Forms	Various	USAC/SLD Forms: 470, 471, 479, 486, 500 & 472
IRS W-9 Form	W-9	IRS W-9 Taxpayer Identification Number
OCC OUSF Form for Credits	Ongoing	Oklahoma schools - provide this completed form to your service provider so they can issue OUSF credits for Internet circuit charges (updated with 1.5M Credit)
2011 Choose Your Group Calendar	Fall 2011	Choose the group you want to be in based upon the deadline for completing your RFP Questionniare and first version Technology Plan for FY 2012-13.
NSLP-Special Sites Form	Fall 2011	Use this form to report special buildings or new construction sites. Return with your E-rate Discount (NSLP) information.
Income Survey	Fall 2011	Distribute to students starting Spring 2011 through Fall 2011. Survey can be used to determine your school's E-Rate discount using the Alternative Discount Method.
Survey Summary	Fall 2011	If you use the Household Income Survey, use this form to summarize your results.
NSLP Certification Form	Fall 2011	Place this form on your letterhead, complete and return to KSLLC with your NSLP information.
Board Items	Jun10	Items to discuss at your June/July 2010 Board Meeting
CIPA Certification	August 2011	KSLLC Clients: Use this form to certify compliance with the Children's Internet Protection Act, including a cyberbullying awareness curriculum declaration.
Form 470/RFP Contact Form	Fall 2011	KSLLC Clients: Designate your RFP contact, and alternate 470 contact (optional), and provide the link to your SP Q&A Forum.
Contact Update	Ongoing	KSLLC Clients: Use this form to send us contact information for your school or library
Equipment Transfer Rules & USAC Notification Form	Ongoing	Information regarding equipment transfers. Use the attached form if you move E-Rate funded equipment within the 3 year non-transfer period.
Service Provider Change Request Form	Ongoing	KSLLC Clients: Use this form to notify us that you would like to change service providers (vendors)
Service Substitution Request (SSR) Form	Ongoing	KSLLC Clients: Use this form to notify us that you would like to change products and services on your existing E-Rate funding.
Internal Connections Extension Request	Ongoing	KSLLC Clients: Use this form to notify us that you would like to request a service delivery deadline extension for internal connections past the Sept 30th deadline.
Invoice Extension Request	Ongoing	KSLLC Clients: Use this form to authorize KSLLC to file an invoice extension request past October (recurring services) or January (non-recurring services) deadline.
VoIP Specifications	Sep 2011	KSLLC Clients requesting NEW VoIP phone systems for 2012-13. Use this form to provide details for bidders about your phone system needs.
Server Allocation	Sep 2011	KSLLC Clients: Use this form to specify the eligible use of servers and supporting server items requested for FY 2012-13. Also used to report usage of existing servers for which basic maintenance is being requested.
Basic Mtc Detail	Sep 2011	KSLLC Clients: Optional form to provide us with your list of equipment for maintenance.
E-Rate Discount	Nov 2011	KSLLC Client Schools: Low Income and Enrollment information needed to establish your E-Rate discount.
Accepted Bids Y15	Nov 2011	KSLLC Clients: Use this form to list your accepted bids for 2012-13.
Bid Scoring	Nov 2011	KSLLC Clients: Use this form to score your bids for E-Rate 2012-13.
TPC Questionnaire	August 2011	KSLLC Clients: Use this fillable form to to complete the first version technology plan.

Applicant Forms

Applicant Forms

Form

#

Description