Application Form

This document pretains to DNC-NEW-20160808-00001 for New Application on a Data Network Code filing.

DATA NETWORK IDENTIFICATION CODE FILING FOR OFFICIAL USE ONLY

APPLICANT INFORMATION

Enter a description of this application to identify it on the main menu:

IB DATA NETWORK CODES ASSIGNMENT 001 cage code 6gef3 DLA

1. Applicant Name: MARCUS TYRONE TRAVENIA Phone Number: 360-388-6475 DBA Name: Fax Number: NONE Street: 1265 LISA LN SE APT 101 E-Mail: [email protected] City: LACEY State: WA Country: USA Zipcode: 98503 - Attention: Mr MARCUS T TRAVENIA
2. Contact Name: MARCUS TYRONE TRAVENIA Phone Number: 360-388-6475 Company: MARCUS TYRONE TRAVENIA Fax Number: NONE Street: 1265 LISA LN SE APT 101 E-Mail: [email protected] City: LACEY State: WA Country: USA Zipcode: 98503 - Attention: Relationship: Same
3. Type Request New Reassign Note: Please submit any needed attachments for the given request type: Attachment 1: Attachment 2: Attachment 3:	4. Reassign Reason: Never Requested data voice and video Codes From Company: MTC MATRIXES To Company: MARCUS TYRONE TRAVENIA From Code: IDM To Code: LTE
5. Network Name BACKBONE WIDEBAND KEYBOARD VOICE AND VIDEO NETWORK
6. International Service Computing And Communications Infrastructure (NSC) Voice Tellia Carrier 1.0
7. Action Requested Please assign My Company MARCUS TYRONE TRAVENIA DATA NETWORK CODES FOR MY 3 DYNAMICAL S.E.S SERVICES SINGLE AND INTEGRATE. This would be the first time ATOMIC,. I am also ATOMIC.
8. Code assignments held in excess of 18 months without implementation must be returned to this Administrator for reassignment. Unless this office is specifically notified of the actual implementation of assignments, it will be assumed that those implementations did not occur and such assignments will be available for reassignment. I have read and understand these conditions. Yes No
9. I am aware that all DNIC assignments are provisional and that nobody has a property right in a DNIC. I am aware that the Commision may take an assigned DNIC and reassign it to another person. Yes No
10. I certify that all necessary local, state, and federal authorizations needed have been obtained. 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).