CCNA

PON

ICSC

ASC-EC

LAST SAVED

CUS 

OHS 

CP88 

1/8/2007 11:19 am 

VER

STATUS

D/T SENT

1 

DRAFT 

STATE

D/T UPDATED

REQTYP

ACT

ACTI

RTR

EXP

SUP

SD 

N 

S 

UNIT

QTY

QTY

NOR

QSA

TQ

AFO

QNAI

EVCI

C 

1 

 of  

DDD

CBD

PPTD

PFPTD

FDT

12 - 30 - 08 

 -  -  

 -  -  

  :   

CKR

ECCKT

FNI

FNT

RFNI

CFNI

ACTL

PBT

AI

APOT

LATA

LA

LANM

LADATED

BLTPMDHMW02 

 -  -  

LTP

ASG

TSC

CC

UNE

BSA

PSL

PSLI

WST

ISTN

 -  -  

PIU

PLU

LUP

BAN

CUST

FBA

EF

DT

MUX

100 

E  -  

YOUR COMPANY 

SPEC

PROJECT

CNO

QA

AENG

ALBR

AGAUTH

DATED

FB12345

 -  -  

BIC

BIC TEL

BIC ID

TSP

SAN

AFG

 -  -  

 -  

RORD

RPON

CCVN

BILLNM

SBILLNM

ACNA

TE

EBP

COMPANY BILLING NAME 

DEPARTMENT FOR BILLING 

ABC 

G 

STREET

FLOOR

ROOM

CITY

STATE

ZIP CODE

WHERE BILL IS TO BE SENT 

ANYWHERE 

TX 

12345 -  

BILLCON

BILLCON EMAIL

TEL NO

ACCTS PAYABLE 

888 - 888 - 8888 -  

VTA

VCVTA

IWBAN

5TTP 

 -  -   

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 

TX 

12345 -  

IMPCON

TEL NO

MTCE

TEL NO

TECH ON DUTY 

888 - 888 - 8888 -  

 -  -  

REQUEST FOR OPTICAL HUBBING SERVICE 

VTA: CUSTOMER MUST IDENTIFY THE TERM 

WHEN THIS PRODUCT IS ORDERED  UNDER A PRIVATE CARRIAGE AGREEMENT (FORBEARANCE), THE CONTRACT  ID MUST BE POPULATED IN THE CNO FIELD ON THE ASR FORM.

CCNA

PON

ICSC

ASC-EC

LAST SAVED

CUS 

OHS 

CP88 

1/8/2007 11:19 am  

VER

STATUS

D/T SENT

1 

DRAFT 

STATE

D/T UPDATED

NC

NCI

SECNCI

PQPR

QPR

CWBB 

04FMF.008 .  

 .  .  .  .  

TLV

SECTLV

  .  T   .  R 

  .  T   .  R

NSL

CKLT

MST

NVC

CLK

PSPEED

LMP

N/U

ZLG

BSC

ETET

MUXLOC

SSS

ATN

SR

ISDN SEQ

TRF

HVP

NSIM

 of  

WACD1

WACD2

CTX TEL

CTX LSTD NM

 -  -  

CFAU

DES

TYPE

CHAN

A LOCATION

Z LOCATION

CFA:  

/

/

/

/

PRIADM

DIR

CPT

 -  

HBAN

  -  

CCEA

SECLOC

S25

ER

OTC

 C BLTPMDXXXXX 

A 

DES

TYPE

CHAN

A LOCATION

Z LOCATION

SCFA:  

/

/

/

/

SECADM

SDIR

GETO

GBTN

GCON

GTEL

 -  -  

 -  -  -  

SCCEA

S25 IS BASED ON CORRECT EXEMPTION FORMS SUBMITTED