Regulatory and Telephone Company Requirements Passport4400 Hardware Installation Manual
B-15
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 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 analog
content and billing protection specifications with respect to 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
encoded billing protection information continuously complies with Part 68 of
the FCC Rules and Regulations.
( ) The digital CPE does not transmit digital signal containing encoded analog
content or billing 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
( )_____c. An independent training course (e.g., trade school or technical
institution) recognized by the manufacturer/grantee of the equipment used to
encode analog signal; or
( )_____d. In lieu of the preceding training requirements, the operation(s)/
maintainer(s) is (are) under the control of a supervisor trained in accordance
with _____(circle one) above.
I agree to provide____________________(telco’s name) with proper
documentation to demonstrate compliance with the information as provided in
the preceding paragraph, if so requested.
____________________(signature)
____________________(title)
____________________(date)
Subscribed and Sworn to before me this _____day of_________,(year)
______________________________
Notary Public
My commission expires: