ADTRAN IQ 710 System Manual page 8

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 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 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 signals containing encoded analog content or billing informa-
tion 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 cus-
tomer.
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 sig-
nals; or
( ) C. An independent training course (e.g., trade school or technical institution) recognized by the man-
ufacturer/grantee of the equipment used to encode analog signals; or
( ) D. In lieu of the preceding training requirements, the operator(s)/maintainer(s) is (are) under the con-
trol of a supervisor trained in accordance with _________ (circle one) above.
IQ 710 System Manual © 2002 ADTRAN, Inc.