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Gross Receipts Mailings Name Title M. Universal Service Fund Mailings Name Title L. Interim LEC Fund Mailings Name Title K. AUTHORIZED UTILITY REPRESENTATIVE FORM FOR TELECOMMUNICATIONS CARRIERS TYPE IXC CLEC ILEC Wireless CERTIFICATED COMPANY INFORMATION Company Name Dba/fka Telephone Mailing Address City State Zip Code Business Location County REGISTERED AGENT INFORMATION Registered Agent Pursuant to the Commission s rules and regulations print or type company contact for the following...

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