507 Preloan Procedures and Requirements for Telecommunicatio

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1. DATE PREPARED

United States Department of Agriculture

-

Rural Utilities Service

-

2. SYSTEM DESIGNATION

REPORT ON TELEPHONE
ACQUISITIONS

3. NAME AND ADDRESS OF BORROWER

I. SYSTEM DATA
8. PURCHASE PRICE

4. NAME AND ADDRESS OF SELLING COMPANY

FOR: (check one)
$

PHYSICAL ASSETS

STOCK

TOTAL

9. SYSTEM DESCRIPTION
a. No. of Exchanges
5. NAME OF SELLER'S MANAGER

b. No. of Subscribers
c. No. of Held Applications

6. TYPE OF ORGANIZATIONS: (check one)

d. Mobile Radio Telephones in Service

INDIVIDUALLY OWNED

PARTNERSHIP

CORPORATION

COOPERATIVE

e. Cellular Units in Service
f. Paging Units in Service
g. Paystations

7. LIST OF OWNER & SPOUSES IF INDIVIDUALLY OWNED OR PARTNERSHIP.
MAJORITY STOCKHOLDERS IF CORPORATION:

h. Services Stations
i. Official Stations
j. No. of Toll Trunk Terminations
k. No. of EAS Trunk Terminations
l. Square Miles Served
m. Access Lines Per Square Mile
n. Route Miles of Lines
o. Subscribers Per Route Mile

II. DATA BY EXCHANGE
1. BUILDING

3. COE - TYPE: (if applicable)

a. Size:

HOST

b. Use:

LINES EQUIPPED

LINES WORKING

REMOTE
4. TOWNS OF OVER 5,000 WHERE SERVICE IS PROVIDED

c. Type of Construction:

POPULATION

NAME

NO. OF SUBS.

2. ROUTE MILES OF LINE

5. GRADE OF
SERVICE

SUBSCRIBER
1-PTY

BUSINESS

RESIDENCE

RUS Form 507 (Rev. 9-03)

2-PTY

4-PTY

RATE
-PTY

TOTAL

1-PTY

2-PTY

4-PTY

-PTY