Fcc Form 499-A - Telecommunications Reporting Worksheet - 2003 Page 3

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2003 FCC Form 499-A Telecommunications Reporting Worksheet
Page 3
Block 2-C: FCC Registration and Contact Information
Carriers must refile Blocks 1, 2 and 6
if there are any changes in this section. See Instructions.
219 Filer 499 ID [from Line 101]
220 Legal name of reporting entity [from Line 102]
221 Chief Executive Officer (or, highest ranking company officer
if the filing entity does not have a chief executive officer)
check if same as Line 109
222 Business address of individual named on Line 221
223 Second ranking company officer, such as Chairman,
but not the individual listed on Line 221
check if same as Line 109
224 Business address of individual named on Line 223
225 Third ranking company officer, such as President or Secretary,
but not either of the individuals listed on Lines 221 or 223
check if same as Line 109
226 Business address of individual named on Line 225
227 Indicate jurisdictions in which the filing entity provides telecommunications service. Include jurisdictions in which service was provided in the past 15 months and
jurisdictions in which service is likely to be provided in the next 12 months.
Alabama
Guam
Massachusetts
New York
Tennessee
Alaska
Hawaii
Michigan
North Carolina
Texas
American Samoa
Idaho
Midway Atoll
North Dakota
Utah
Arizona
Illinois
Minnesota
Northern Mariana Islands
U.S. Virgin Islands
Arkansas
Indiana
Mississippi
Ohio
Vermont
California
Iowa
Missouri
Oklahoma
Virginia
Colorado
Johnston Atoll
Montana
Oregon
Wake Island
Connecticut
Kansas
Nebraska
Pennsylvania
Washington
Delaware
Kentucky
Nevada
Puerto Rico
West Virginia
District of Columbia
Louisiana
New Hampshire
Rhode Island
Wisconsin
Florida
Maine
New Jersey
South Carolina
Wyoming
Georgia
Maryland
New Mexico
South Dakota
PERSONS MAKING WILLFUL FALSE STATEMENTS IN THE WORKSHEET CAN BE PUNISHED BY FINE OR IMPRISONMENT UNDER TITLE 18 OF THE UNITED STATES CODE, 18 U.S.C. §1001
FCC Form 499-A
February 2003

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