I attest that 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 having completed one of the following: (Check appropriate blocks)
(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 information; or
(d) In lieu of the proceeding training requirements, the operator(s)/maintainer(s) is (are) under the control
of a supervisor trained in accordance with (circle one) above.
I agree to provide (telco name) with the proper documentation to
(Telco's Name)
demonstrate compliance with the information as provided in the preceding paragraphs, if so requested.
(Signature)
(Title) B)
(Date)
Subscribed and sworn to before me this day of , B
B
Notary Public
My commission expires: d
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