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Sample Entity Validation Letter

This letter is a sample for applicants to submit to the California Department of Education when requesting third party validation for entities in response to an E-rate program integrity review letter from the Universal Service Administrative Company.

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Doug Jones, Superintendent
3298 Sample Drive
Ejemplo, CA 90008

Entity Validation Letter

March 9, 2018

State E-rate Coordinator
California Department of Education
1430 N Street, Suite 6308
Sacramento CA. 95814

To Whom It May Concern:

I certify that: (1) each of the school site(s) listed in the letter has been established, organized, maintained, and operated as an independent “school,” rather than a secondary site, by official action of the governing board (or the authorizing board of a Charter School) and such action is reflected in the governing board’s minutes; (2) each of such schools meets the statutory definition of an elementary school or secondary school found at 20 U.S.C. section 7801 (19) and (45), and/or the Eligibility for non-traditional K-12 students and facilities as found on the Schools and Libraries Division (SLD), Universal Service Administrative Company (USAC) website.

I certify that all information contained in this certification letter and its attachments are true and accurate and supported by written documentation maintained in the entity’s official records of which will be made available promptly upon request. I acknowledge, on behalf of the governing board, that USAC distinguishes between an “annex” and a “school” and that, if USAC determines during an audit or otherwise that a school site is not a separate “school” but rather an “annex,” the local educational agency (LEA) could incur a significant liability or disallowance.

Thank you for your assistance in this matter.



Doug Jones
Ejemplo City Schools


Ejemplo School District (CDS code: 72203980000000)

School of NIF Name
School Program Type
CDS Code
(If known)
Entity Number
Principal Name
Ejemplo Elementary School K-12 72203981123456 4567752

34 Main Street Wilton CA 95643

Bill Anderson

Parkside Elementary School K-12 72203981123457 4567751

127 Jones Street Wilton CA 95643

Sally Jenkins

Ejemplo Middle School K-12 72203981123458 4567749

17 Hamilton Street Wilton CA 95643

Rhonda Jones

Ejemplo High School K-12 72203981123459 4567748

520 Hampton Blvd Wilton CA 95643

Leslie Peters

Ejemplo Maintenance Facility (NIF)

K-12 N/A 4567768

39 Hampton Blvd Wilton CA 95643

Tom Sullivan

Questions:   E-rate |
Last Reviewed: Thursday, March 18, 2021
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