ADTRAN TSU 120e - Manual (Page 10)

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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 dig-
ital services. The terminal equipment to be connected complies with
Part 68 of the FCC rules except for the encoded analog content and bill-
ing protection specifications. With respect to encoded analog content
and billing protection:
( ) I attest that all operations associated with the establishment, main-
tenance, and adjustment of the digital CPE with respect to analog con-
tent 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 information 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 customer.
I attest that the operator(s)/maintainer(s) of the digital CPE responsible
for the establishment, maintenance, and adjustment of the encoded an-
alog content and billing information has (have) been trained to perform
these functions by successfully having completed one of the following
(check appropriate blocks):