Form FCC-507 Line Count Report for Interstate Common Line Support Mec

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Overview

PATH 1 LINE COUNT REPORT
PATH 2 AND 3 LINE COUNT REPORT
CERTIFICATION-REPORTING CARRIER
CERTIFICATION-AGENT
NOTICE

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Sheet 1: PATH 1 LINE COUNT REPORT

LINE COUNT DATA COLLECTION FOR PATH 1 CARRIERS
Block 1 - Contact Information
ROW #	DATA ELEMENT	FORMAT OF REQUESTED DATA	RESPONSE				NO. OF ACQUIRED LINES
1	Carrier Study Area Code	6 numeric digits
2	Carrier Study Area Name	alpha characters
3	Service Provider Identification Number	9 numeric digits
4	Data As Of	mm/dd/yyyy
5	Disaggregation Path Selected by Incumbent Carrier	Identify Path 1
6	Contact Name	alpha characters
7	Contact Telephone Number [including area code]	10 numeric digits
Block 2 - Line Counts
8	Residential and Single-Line Business Access Lines in Service	numeric digits
9	Multi-Line Business Access Lines in Service	numeric digits
10	Total Number of Access Lines in Service in Study Area	numeric digits
11	Name of Carrier From Which Lines Were Acquired, If Applicable	alpha characters
12	Study Area Code From Which Lines Were Acquired, If Applicable	6 numeric digits

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Sheet 2: PATH 2 AND 3 LINE COUNT REPORT

LINE COUNT DATA COLLECTION FOR PATH 2 AND PATH 3 CARRIERS
Block 1 - Contact Information
ROW #	DATA ELEMENT			FORMAT OF REQUESTED DATA	RESPONSE
1	Carrier Study Area Code			6 numeric digits
2	Carrier Study Area Name			alpha characters
3	Service Provider Identification Number			9 numeric digits
4	Data As Of			mm/dd/yyyy
5	Disaggregation Path Selected by Incumbent Carrier			Identify Path 2 or Path 3
6	Contact Name			alpha characters
7	Contact Telephone Number (include area code)			9 numeric digits
8	Sheet number			numeric digit(s)
9	Total Number of Sheets			numeric digit(s)
Block 2 - Line Counts for Each Disaggregation Zone (Complete One Line for Each Zone)					Block 3 - Acquired Lines Not Included in a Previously Submitted Line Count Report
	Column 1 Disaggregation Zone Name	Column 2 Residential and Single-Line Business Access Lines in Service	Column 3 Multi-Line Business Access Lines in Service	Column 4 Total Number of Access Lines in Service	Column 5 Acquired Residential and Single-Line Business Access Lines in Service	Column 6 Acquired Multi-Line Business Access Lines in Service	Column 7 Acquired Total Number of Access Lines in Service	Column 8 Name of Carrier From Which Lines Were Acquired	Column 9 Study Area Code From Which Lines Were Acquired
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Sheet 3: CERTIFICATION-REPORTING CARRIER

TO BE COMPLETED BY THE REPORTING CARRIER, IF THE REPORTING CARRIER IS FILING FCC FORM 507 ON ITS OWN BEHALF:

Certification of Officer or Employee as to the Accuracy of the Data Reported in FCC Form 507, Line Count Report for Interstate Common Line Support Mechanism, on Behalf of Reporting Carrier

Name of Reporting Carrier

Signature of authorized officer or employee

Date

Printed name of authorized officer or employee

Title or position of authorized officer or employee

Telephone number of authorized officer or employee: ( _ _ _ ) _ _ _ - _ _ _ _, ext. _ _ _ _ _

Study Area Code of Reporting Carrier

Filing Due Date for this form (mm/dd/yyyy)

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Sheet 4: CERTIFICATION-AGENT

TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING FCC FORM 507 ON THE CARRIER'S BEHALF:

Certification of Officer or Employee to Authorize an Agent to File FCC Form 507, Line Count Report for Interstate Common Line Support Mechanism, on Behalf of Reporting Carrier

Name of Authorized Agent

Name of Reporting Carrier

Signature of authorized officer or employee

Date

Printed name of authorized officer or employee

Title or position of authorized officer or employee

Telephone number of authorized officer or employee: ( _ _ _ ) _ _ _ - _ _ _ _, ext. _ _ _ _ _

Study Area Code of Reporting Carrier

Filing Due Date for this form (mm/dd/yyyy)

TO BE COMPLETED BY THE AUTHORIZED AGENT:

Certification of Agent Authorized to File FCC Form 507, Line Count Report for Interstate Common Line Support Mechanism, on Behalf of Reporting Carrier

Name of Reporting Carrier

Name of Authorized Agent

Signature of authorized agent or employee of agent

Date

Printed name of authorized agent or employee of agent

Title or position of authorized agent or employee of agent

Telephone number of authorized agent: ( _ _ _ ) _ _ _ - _ _ _ _, ext. _ _ _ _ _

Study Area Code of Reporting Carrier

Filing Due Date for this form (mmddyyyy)

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Sheet 5: NOTICE