Specifications

APPENDIX B: TELCO Affidavit

I attest that the operator(s)/maintainer(s) of the digital CPE responsible for the establishment,

maintenance and adjustment of the encoded analog content and billing information has (have) been

trained to perform these functions by successfully completing one of the following (Check appropriate

one(s))

a. A training course provided by the manufacturer/grantee of the equipment used to encode

analog signals; or

b. A training course provided by the customer or authorized representative, using training

materials and instructions provided by the manufacturer/grantee of the equipment used to

encode analog signals; or

c. An independent training course (e.g., trade school or technical institution) recognized by the

manufacturer/grantee of the equipment used to encode analog signals; or

d. In lieu of the preceding training requirements, the operator(s)/maintainer(s) is (are) under

control of a supervisor trained in accordance with __________ above.

(circle one)

I agree to provide_________________________with proper documentation to demonstrate compliance

with the information as provided in the preceding paragraph, if so requested.

Signature ____________________________________

Title ________________________________________

Date ________________________________________

Subscribed and Sworn to before me

this _______day of_____________________,19_____

_____________________________________________

Notary Public

My commission expires: _______________________