ADTRAN Atlas 550 System Manual page 10

Adtran atlas 550: user guide

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Affidavit for Connection Of Customer Premises Equipment

ATLAS 550 System Manual

I agree to provide ______________________ (telco's name) with proper documentation to

demonstrate compliance with the information as provided in the preceding paragraph, if so

_________________________________Signature

_________________________________Title

_________________________________ Date

Transcribed and sworn to before me

This ________ day of _______________, _______

_________________________________

Notary Public

My commission expires:

_________________________________

61200305L2-1B

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