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PRIVATE LINE

NOTE:

ATTACH AN AFFIDAVIT MARKED “ΑEXHIBIT C” SHOWING EACH INCUMBENT LOCAL

EXCHANGE COMPANY (LEC) EXCHANGE SERVICE AREA YOU PROPOSE TO SERVE.

2. LIST BELOW NAME AND MAILING ADDRESS OF ALL PARTIES WHO OPERATE TELEPHONE FACILITIES ADJACENT TO

THOSE FOR WHICH A CERTIFICATE IS REQUESTED HEREIN; INCLUDE ALL PERSONS WHO WOULD BE INTERESTED

IN THIS APPLICATION BY REASON OF THE PROXIMITY OF THE FACILITIES OR THE PROPOSED FACILITIES. FAILURE

TO ANSWER THIS QUESTION COMPLETELY IS CAUSE FOR DENYING APPLICATION.

NAME OF PERSON, FIRM OR CORPORATION

ADDRESS

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3. WHAT CUSTOMER CLASS(ES) DOES THE APPLICANT PROPOSE TO SERVE? ___________________________________

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4. IF AUTHORITY SOUGHT IS FACILITIES-BASED, ANSWER THE FOLLOWING:

A) WHAT FACILITIES DO YOU CURRENTLY HAVE DEPLOYED IN GEORGIA? (PROVIDE DETAILED MAP.)

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B) HOW ARE THESE FACILITIES CURRENTLY BEING UTILIZED?

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C) WHAT FACILITIES DO YOU PROPOSE TO DEPLOY IN GEORGIA? (PROVIDE MAP AND DETAILED

EXPLANATION.)

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V. AUTHORITY REQUESTED (CONTD.)

5. IF LOCAL SERVICE IS PROPOSED TO BE RENDERED IN AN INCORPORATED AREA OR AREAS, STATE:

A) NAME OF CITY(IES) PROPOSED TO BE SERVED FOR WHICH A FRANCHISE IS HELD (ATTACH CERTIFIED

COPIES OF ALL FRANCHISES HELD UNLESS ALREADY ON FILE WITH THE COMMISSION).

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GPSC FORM 900-1

Electronic Version

Gpsc Form 900-1 - Application For Certificate Of Authority To Provide Competitive Local Exchange Service Page 4