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61200375L1-1
TA 850
T1 RCU VoATM UIG/61200376L2-31A
Page 9 of 72
© 2001, ADTRAN, Inc. TA 850 User Manual
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 digital services. The terminal equipment
to be connected complies with Part 68 of the FCC rules except for the encoded analog
content and billing protection specifications. With respect to encoded analog content and
billing protection:
( ) I attest that all operations associated with the establishment, maintenance, and adjustment of
the digital CPE with respect to analog content and encoded billing protection information con-
tinuously 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 establish-
ment, maintenance, and adjustment of the encoded analog content and billing information
has (have) been trained to perform these functions by successfully having completed one of
the following (check appropriate blocks):
( ) A. A training course provided by the manufacturer/grantee of the equipment used to encode
analog signals; or
( ) B. A training course provided by the customer or authorized representative, using training
materials and instructions provided by the manufacturer/grantee of the equipment used to
encode analog signals; or
( ) C. An independent training course (e.g., trade school or technical institution) recognized by
the manufacturer/grantee of the equipment used to encode analog signals; or
( ) D. In lieu of the preceding training requirements, the operator(s)/maintainer(s) is (are) under
the control of a supervisor trained in accordance with _________ (circle one) above.