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B) NAME OF CITY(IES) PROPOSED TO BE SERVED FOR WHICH NO FRANCHISE IS HELD.

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6. NAME OF MUNICIPALITY IN WHICH EXCHANGE IS LOCATED FROM WHICH TELEPHONE SERVICE WILL BE

RENDERED BY THE PROPOSED FACILITIES.

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7. NAME OF NEWSPAPER HAVING MOST GENERAL CIRCULATION IN SAID MUNICIPALITY.

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8. NAME OF CHIEF EXECUTIVE OFFICER OF EACH MUNICIPALITY.

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9. IF AUTHORITY SOUGHT IS RESALE, WHAT SPECIFIC NETWORK FUNCTIONALITIES OR TELECOMMUNICATION

SERVICES DO YOU SEEK TO RESELL?

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10. HOURS SERVICE IS TO BE PROVIDED. _____________________________________________________________________

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VI. FACILITIES BASED

QUESTIONS 1, 2, 3, 4 AND 5 ARE TO BE SUPPLIED ONLY BY APPLICANTS FOR CERTIFICATES TO PURCHASE, LEASE,

ACQUIRE OR OPERATE FACILITIES CERTIFICATED BY ANOTHER PERSON.

1. NAME OF COMPANY THAT NOW HOLDS CERTIFICATE FOR FACILITIES TO BE ACQUIRED.

__________________________________________________________________

CERTIFICATE NO. _________________

__________________________________________________________________

CERTIFICATE NO. _________________

2. COMPLETE DESCRIPTION OF FACILITIES TO BE ACQUIRED. (PROVIDE MAPS.)

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VI. FACILITIES BASED (CONTD.)

3. PROPERTY TO BE ACQUIRED BY:

PURCHASE [

]

LEASE [

]

OTHER [

]

4. A) IF BY PURCHASE, GIVE PRICE AND OTHER CONSIDERATIONS.

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B) IF BY LEASE, GIVE TERMS OF LEASE (ANNUAL RENTAL, TERM, CONSIDERATION, ETC.)

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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 5