Application Form

This document pretains to ARC-MOD-20030422-00020 for Modification on a Accounting Rate Change filing.

Approved by OMB
3060-0454
FEDERAL COMMUNICATIONS COMMISSION
APPLICATION FOR AN ACCOUNTING RATE CHANGE


FOR OFFICIAL USE ONLY

APPLICANT INFORMATION


Enter a description of this application to identify it on the main menu:
1. Applicant
AT&T 908-532-1911
908-532-1281
One AT&T Way [email protected]
Bedminster NJ
USA 07921 -
Mr Steven A Sillett
2. Contact
Steven Sillett 908-532-1911
AT&T 908-532-1281
One AT&T Way [email protected]
Bedminster NJ
USA 07921 -
Litigation Assistant
3. Application Type:
Modification of Existing Accounting Rate Petition for Declaratory Ruling
4. U.S. Carrier: AT&T 5. Foreign Carrier: Palau national Telecommunications Corporation (PNCC)
6. Foreign Point Being Served: Palau

7. 1: Palau 2: 3:

SERVICE INFORMATION
S1. U.S. Carrier: AT&T S2. Foreign Carrier: Palau national Telecommunications Corporation (PNCC)
S3. Foreign Point Being Served: Palau
S4. Service: IMTS
S5. Current Rate: $1.00 S6. New Rate: $0.286 S7. Surcharge: NONE
S8. Effective Date: 01/01/2003 S9. Expire Date:
S10. [50/50]: Yes No S11. Proportionate Return: Yes No

WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND / OR IMPRISONMENT
(U.S. Code, Title 18, Section 1001), AND/OR REVOCATION OF ANY STATION AUTHORIZATION
(U.S. Code, Title 47, Section 312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47, Section 503).


The public reporting for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the required d ata, and completing and reviewing the collection of information. If you have any comments on this burden estimate, or how we can improve the collection and reduce the burden it causes you, please write to the Federal Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-0454), Washington, DC 20554. We will also accept your comments regarding the Paperwork Reduction Act aspects of this collection via the Internet if you send them to [email protected]. PLEASE DO NOT SEND YOUR RESPONSE TO THIS ADDRESS.

Remember - You are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060-0454.


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