Gpsc Form 900-1 - Application For Certificate Of Authority To Provide Competitive Local Exchange Service Page 10
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14APPLICATION, INCLUDING ACCOMPANYING STATEMENTS AND ATTACHMENTS ARE TRUE, COMPLETE AND
CORRECT. I UNDERSTAND THAT ANY FALSE OR MISLEADING INFORMATION IN, OR IN CONNECTION WITH MY
APPLICATION MAY BE CAUSE FOR DENIAL OR LOSS OF CERTIFICATE.
_______________________________________________
(SIGNATURE)
_______________________________________________
(DATE)
SUBSCRIBED AND SWORN BEFORE ME THIS __________
DAY OF _________________, 20_________
(SEAL)
________________________________________________
(NOTARY PUBLIC)
GPSC FORM 900-1
Electronic Version
10
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