CCNA

PON

VER

ICSC

ASC-EC

D/T Transmitted

D/T Last Rec

LAST SAVED

CUS 

123-DISC-DS1-32 

1 

CP88 

5/2/2006 1:10 pm 

ASR STATUS

C/NR STATUS

DRAFT 

None 

REQTYP

ACT

ACTI

RTR

EXP

SUP

SD 

D 

S 

UNIT

QTY

QTY

NOR

QSA

TQ

AFO

C 

1 

 of 1 

01 

DDD

CBD

PPTD

PFPTD

FDT

05 - 08 - 06 

 -  -  

 -  -  

  :   

CKR

12XXX123456.001 

ECCKT

12/HCGS/123456/CV 

FNI

FNT

CFNI

ACTL

PBT

AI

APOT

LATA

LA

LANM

LADATED

ABCDVAABCVC 

 -  -  

LTP

ASG

TSC

CC

UNE

BSA

PSL

PSLI

WST

WSTN

 -  -  

PIU

PLU

LUP

BAN

CUST

FBA

EF

DT

MUX

100 

123 ABC - 1234 

YOUR COMPANY 

SPEC

PROJECT

CNO

QA

AENG

ALBR

AGAUTH

DATED

 -  -  

BIC

BIC TEL

BIC ID

TSP

SAN

AFG

 -  -  

 -  

RORD

RPON

CCVN

BILLNM

SBILLNM

ACNA

TE

EBP

COMPANY BILLING NAME 

DEPARTMENT FOR BILLING 

ABC 

L 

STREET

FLOOR

ROOM

CITY

STATE

ZIP CODE

WHERE BILL IS TO BE SENT 

ANYWHERE 

NC 

12345 -  

BILLCON

BILLCON EMAIL

TEL NO

ACCTS PAYABLE 

888 - 888 - 8888 -  

VTA

VCVTA

IWBAN

7TPP 

 -  -   

INIT

TEL NO

INIT FAX NO

JOHN/JANE DOE 

888 - 888 - 8888 -  

 -  -  

INIT EMAIL

JOHN.JANE.DOE@YOURCOMPANY 

STREET

FLOOR

ROOM

CITY

STATE

ZIP CODE

 -  

DSGCON

TEL NO

DSG FAX NO

DRC

FDRC

JANE/JOHN DOE 

888 - 888 - 8888 -  

999 - 999 - 9999 

DSG EMAIL

JOHN.JANE.DOE@YOURCOMPANY 

STREET

FLOOR

ROOM

CITY

STATE

ZIP CODE

1111 MAIN BLVD 

ANYWHERE 

NC 

12345 -  

IMPCON

TEL NO

MTCE

TEL NO

TECH ON DUTY 

888 - 888 - 8888 -  

 -  -  

DISCONNECT SERVICE 

CCNA

PON

VER

ICSC

ASC-EC

D/T Transmitted

D/T Last Rec

LAST SAVED

CUS 

123-DISC-DS1-32 

1 

CP88 

5/2/2006 1:10 pm 

ASR STATUS

C/NR STATUS

DRAFT 

None 

NC

NCI

SECNCI

PQPR

QPR

HCE- 

04DS6 . 44 .  

04DU9 . 1SN .  .  .  

TLV

SECTLV

  .  T   .  R 

  .  T   .  R

NSL

CKLT

MST

NVC

CLK

PSPEED

LMP

N/U

ZLG

BSC

ETET

MUXLOC

SSS

ATN

ABCDVAQN 

SR

ISDN SEQ

TRF

HVP

NSIM

 of  

WACD1

WACD2

CTX TEL

CTX LSTD NM

 -  -  

CFAU

DES

TYPE

CHAN

A LOCATION

Z LOCATION

CFA:  

1000 

/

T3Z 

/

9 

/

ABCDNYABC10 

/

ABCDNYDEF10 

PRIADM

DIR

CPT

 -  

HBAN

  -  

CCEA

SECLOC

S25

ER

OTC

E  

A 

DES

TYPE

CHAN

A LOCATION

Z LOCATION

SCFA:  

/

/

/

/

SECADM

SDIR

GETO

GBTN

GCON

GTEL

 -  -  

 -  -  -  

SCCEA

CCNA

PON

VER

ICSC

ASC-EC

D/T Transmitted

D/T Last Rec

LAST SAVED

CUS 

123-DISC-DS1-32 

1 

CP88 

5/2/2006 1:10 pm  

ASR STATUS

C/NR STATUS

DRAFT 

None 

REF NUM

PI

AFT

0001 

EUNAME

NCON

MY COMM COMPANY 

SAPR

SANO

SASF

1234 

SASD

RR

ROUTE#

STREET NAME

SATH

SASS

WATER TOWER 

RD 

LD1

LV1

LD2

LV2

LD3

LV3

BLDG 

TELCO 

CITY

STATE

ZIP

ANYTOWN 

NY 

12345 -  

ADDITIONAL ADDRESS INFORMATION

JS

JK CODE

SMJK

JK NUM

JK POS

PCA

REN

N 

RJ48C 

99 

99 

SI

SPOT

ICOL

LCON

ACTEL

AACTEL

ACPGN

ACPPN

JOE 

999 - 999 - 9999 -  

 -  -  -  

 -  -  

ALCON

ALCON TEL

 -  -  -  

ACCESS INFORMATION

WKTEL

 -  -