Department of Public Service

Common Carrier - Application Form A


Complete this application to the best of your knowledge. Any inaccuracies or deficiencies will be promptly corrected or the application may be returned.  The applicant must sign and date the application before mailing it along with the initial tariff to: Kathleen H. Burgess, Secretary to the Commission, Three Empire State Plaza, Albany, NY 12223-1350.  If this application is granted, the company must comply with all applicable rules and regulations of the Public Service Commission.
1.    Identification of applicant and principal business office:
  • Company Name
  • Street Address (P.O. Box is not acceptable)
  • City, State, Zip Code
  • President and Telephone/Fax
  • Other Officers and Telephone/Fax
2.    Provide the following Telecommunications Carrier Critical Information Form.
3.    Provide a copy of the company's certificate of incorporation and, if not incorporated in New York State, a copy of the authority to transact business in New York State (foreign business authority). If not incorporated, attach a list of the names, addresses, and telephone numbers of the company's owners.
4.    Include a general description of the services to be offered and how it would enhance competition in the area to be served.
5.    Include a description of the plant and system to be constructed and the anticipated construction schedule.
6.    Include a statement as to whether the company has ever acquired a customer by switching it from another company without the customer's authorization.  If the company has ever acquired a customer by switching it from another company without the customer's authorization, please provide an explanation.
7.    Include a statement as to whether the company was ever the subject of a complaint and/or investigation for unauthorized switching of a customer's local or long distance service from one carrier to another.  If the company was ever the subject of a complaint and/or investigation for unauthorized switching of a customer's local or long distance service from one carrier to another, please provide an explanation.
8.    Provide your company's Federal Social Security Account Number and/or Federal Employer Identification Number.
9.    If applying for authorization to provide local exchange service (residential and/or business dialtone), describe how your company will provide access to public safety/emergency telephone services, access to the statewide relay system and lifeline service. In addition, the applicant must comply with the requirements enumerated on pages 30-31 of the Commission's Order in Case 94-C-0095, issued May 22, 1996. The Commission will entertain waivers of any of these specific requirements only on a case-by-case basis. Please describe briefly how you plan to comply with these requirements. If you do not plan to provide local exchange services, please state so.
10.    If applying for authorization to provide local exchange service (residential and/or business dialtone), indicate whether your company will have "0-" emergency calls processed by the ILEC or other "0-" certified operator services provider, or intends to file a subsequent petition for "0-" certification of its own.
11.  If applying for authorization to provide local exchange service (residential and/or business dialtone), include an intraLATA presubscription implementation plan.
12.   If applying for authorization to provide facilities based local exchange services (residential and/or business dialtone), your company is expected to comply with the Commission's Network Reliability Orders.  On July 28, 2004, the Commission issued an order, in Case 03-C-0922 - Proceeding on Motion of the Commission to Examine Telephone Network Reliability, addressing such items as Telecommunications Service Priority (TSP) rates and procedures, dual cable entrance facilities and a show cause requirement concerning route diversity and a new service, Critical Facilities Administration Service.  A second order, re-addressing Telephone Network Reliability, was issued on June 15, 2005.  In your application, please describe how your company will undertake to comply with these Commission pronouncements.   If you do not plan to provide facilities based local exchange services, please state so.



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