FCC Broadband Fixed Availability Challenge

Please fill out this form if you want to submit your information to the state and have a representative submit challenges to the FCC on your behalf.

1. Please provide your full name:

2. Please provide your contact email:

3. Please provide your contact number:

Phone

4a. Please provide your address:

House number, Street Address, Unit number (if applicable)

4b. Please provide the City associated with your address:

City

4c. Please provide the Zip Code associated with your address:

Zip Code

5. In case we need further information from you, how should we get in touch?

Please pick one option.

Phone Call

E-mail

Either

6. Please select an Internet Provider that you would like to report a concern with:

Pick one option from the Dropdown menu. If you do not see your provider in the list, select 'Other: Provider Not Listed'.

7. What kind of Internet do you currently subscribe to or have tried to subscribe to from the selected Internet Provider?

Please pick one option

8. What Issue are you facing with the Internet Provider selected above?

Pick one option

Provider failed to schedule a service installation within 10 business days of a request.

Provider did not install the service at the agreed-upon time.

Provider requested more than the standard installation fee to connect this location.

Provider denied the request for service.

Provider does not offer the technology entered above at this location.

Provider does not offer the speed(s) shown on the Broadband Map for purchase at this location.

No wireless or satellite signal is available at this location.

Provider reported that new, non-standard equipment is required to connect this location.

Other

9. When did you last reach out to an Internet Provider to report the issue or to get an internet connection?

Please provide an estimated date if you are unsure.

mm/dd/yyyy

10. How did you contact the Internet Provider?

Please pick one option

Phone

Website

Other

11. Please describe your interaction with the Internet Provider when reporting the issue or trying to get an internet connection:

12. Please attach any evidence that might support your interaction with the Internet Provider.

Examples of evidence include emails and other correspondence, screenshots of conversations or websites, or photos of marketing material if relevant.

Files can be uploaded in the following formats: DOC DOCX PNG PDF JPEG

Drop your files here

Send me a copy of my responses