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Affidavit for Connection of Customer Premises Equipment to 1.544 MBPS and/or
Subrate Digital Services
For the work to be performed in the certified territory of ______________ (telco name)
State of ________________________________
County of ______________________________
I, _______________________ (name), ____________________ (business address),
_____________________ (telephone number) being duly sworn, state:
I have the responsibility for the operation and maintenance of the terminal equipment to be
connected to 1.544 Mbps and/or __________________ subrate digital services. The terminal
equipment to be connected complies with Part 68 of the FCC rules except for the encoded ana-
log content and billing protection specification. With respect to encoded analog content and
billing protection:
( ) I attest that all operations associated with the establishment, maintenance and adjustment of
the digital CPE with respect to encoded analog content and billing protection information contin-
uously complies with Part 68 of the FCC rules and Regulations.
( ) The digital CPE does not transmit digital signals containing encoded analog content or bill-
ing information which is intended to be decoded within the telecommunications network.
( ) The encoded analog content and billing protection is factory set and is not under the control
of the customer.
I attest that the operator(s) maintainer(s) of the digital CPE responsible for the establishment,
maintenance and adjustment of the encoded analog content and billing information has (have)
been trained to perform these functions by successfully having completed one of the following
(check appropriate blocks):
( ) A. A training course provided by the manufacturer/grantee of the equipment used to encode
analog signals; or
( ) B. A training course provided by the customer or authorized representative, using training
materials and instructions provided by the manufacturer/grantee of the equipment used to
encode analog signals; or