NEW YORK STATE PUBLIC SERVICE COMMISSION
TELECOMMUNICATIONS COMPANY CRITICAL INFORMATION FORM (TCCI)

What is the TCCI form?
The TCCI form is used to update basic company information in the Department's Telecommunications Company Critical Information Database that is maintained by the Office of Telecommunications. Company information is utilized in a number of Department applications and may be used in emergency situations to quickly correspond with companies.

Who Is Required to File this Form?
  • ALL telecommunications providers including ALL cable television companies regulated by the New York Public Service Commission are required to complete a TCCI form.
  • A company that has applied for certification as a telecommunications carrier in New York State.

When should a company Update the Form?
  • All regulated companies are required to update the form and Stray Voltage Attestation annually September 1 of every year.
  • A company that has changed its name and filed an Adoption Supplement with the New York Public Service Commission.
  • A company that has changes to a previously filed TCCI.
  • A company seeking Commission approval for a merger and/or acquisition, should file once the process has been completed. Note: All companies involved in the merger should complete a new or revised TCCI Form if they will continue to do business in New York.

Instructions:

This form is to be filed electronically, please fill out all fields and press the Submit button when completed. NOTE: If you need a copy of the form for your records, print it before submitting. Do not mail additional copies of the form to the Commission.

*Please be advised: We recommend using Microsoft Internet Explorer 5 or greater.
Users who are not using earlier versions than Microsoft Internet Explorer 5.0 may find that some or all of the features on this page will not function properly.

If you have any questions regarding the completion of this form, contact Mary Broderick (518) 486-2832.

Please Note: If there are subsequent changes to your company's information, submit a revised TCCI form immediately.


Please check only one of the seven following boxes below and follow any applicable instructions for the box chosen.

This form is being submitted because:




Please Note: This company will be listed on our website as Inactive with the Department until a properly completed TCCI form is received.


Please indicate the former company name under "Formerly Known As" below.


Name of the company(ies) that has ceased operations







ALL OF THE FOLLOWING FIELDS MUST BE FILLED OUT OR THIS FORM WILL BE CONSIDERED INCOMPLETE.
IF A FIELD IS NOT APPLICABLE, INDICATE "NA".
Company's Full Registered Name:
Formerly Known As, if applicable

If Providing Cable Service:
Region where providing service:
System:

State in which Certificate of Incorporation filed:

Company Website:

Company Corporate Address:
Line 2 ( Street)
Line 3 (Floor, Etc)
City
State:
Zip:
Attention:

Company President:
First Name:Last Name:
Telephone Number:
Fax Number:
E-mail address:
Mailing address:
Line 2 (Street)
Line 3 (Floor, Etc)
City
State:
Zip:
Attention:

Regulatory Contact:
First Name:Last Name:
Title:
Telephone Number:
Fax Number:
E-mail address:
Mailing address:
Line 2 (Street)
Line 3 (Floor, Etc)
City
State:
Zip:

Regulatory Consumer Complaint Contact:
First Name:Last Name:
Telephone Number:
Fax Number:
E-mail address:
Mailing address:
Line 2 (Street)
Line 3 (Floor, Etc)
City
State:
Zip:
Attention:

IMPORTANT
Customer Contact Telephone Number:

Business Office Contact, Representative or Agent (for billing/assessment purposes):
First Name:Last Name:
Telephone Number:
Fax Number:
E-mail address:
Mailing address:
Line 2 (Street)
Line 3 (Floor, Etc)
City
State:
Zip:
Attention:

By Order issued July 3, 2006 in Case 04-M-0159, the Commission directed all facilities-based telecommunications providers to adhere to appropriate electrical safety codes and attest on an annual basis that they comply with the National Electrical Safety Code and National Electrical Code. Accordingly, by checking the 'yes' box below, I attest that our company's installation, operation, and maintenance practices and procedures are in compliance with applicable National Electrical Safety Code and National Electrical Code.





Company Officer's Name:
First Name:Last Name:
Title:

Form Preparer's Name:
First Name:Last Name:
Telephone Number:
(Area code) + Number
E-mail address:
The opposite of Day is...

Please submit this form by clicking on the SUBMIT button below.
Click Here To Print Completed TCCI Form


 

*Please be advised: We recommend using Microsoft Internet Explorer 5 or greater.
Users who are not using Microsoft Internet Explorer 5.0 may find that some or all of the features on this page will not function properly.