FCC Form 507 Line Count Report

Competitive Carrier Line Count Report and Self-Certification as a Rural Carrier, FCC Forms 481, 507, 508, 509, and 525

Copy of 507 Form.xls

Competitive Carrier Line Count Report and Self-Certification as a Rural Carrier, FCC Forms 525 and 481

OMB: 3060-0986

Document [xlsx]
Download: xlsx | pdf

Overview

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


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

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)





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)




Sheet 5: NOTICE




























File Typeapplication/vnd.ms-excel
File TitleFCC Form 507 (Horizontal)
SubjectOTHR
Last Modified ByNicole Ongele
File Modified2016-04-25
File Created2002-05-06

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