Attachment 20161122155258-630.p

20161122155258-630.p

SUPPLEMENT

Supplement

2001-07-13

This document pretains to ITC-214-20010716-00389 for International Global Resale Authority on a International Telecommunications filing.

IBFS_ITC2142001071600389_1370649

JUL + V LUVi UCTIONS CAREFULLY Approved by OMB JCEEDING FEDERAL COMMUNICATI Streamlined ITC—214—20010716—00389 REMITTANCE MUMBAI TEL, LLC OX # 358115 SECTION A — PAYER I AME (if paying by credit card, enter name exactly as it appears on vour card) (3) TOTAL AMOUNT PAID (U.S. Dollars and cents) . Amend $815.00 .DDRESS LINE NO. 1 II mam_fy miarnit CApn DDRESS LINE NO. 2 TAIU UV VNLUI! uN (7) STATE |(8) ZIP CODE KS 67206 TELEPHONE NUMBER (include area code) (10) COUNTRY CODE (if not in U.S.A.) 1090 FCC REGISTRATION NUMBER (FRN) AND TAX IDENTIFICATION NUMBER (TIN) REQUIRED RN) (12) PAYER (TN) 0004938353 513581706 IF PAYER NAME AND THE APPLICANT NAME ARE DIFFERENT, COMPLETE SECTION B IF MORE THAN ONE APPLICANT, USE CONTINUATION SHEETS (FORM 159—C) NT NAME il, LLC ADDRESS LINE NO. 1 03 ADDRESS LINE NO. 2 (”)‘STATE (18) ZIP CODE KS 67208 3 TELEPHONE NUMBER (includearea code) (20) COUNTRY CODE (if not in U.S.A.) 1090 FCC REGISTRATION NUMBER (FRN) AND TAX IDENTIFICATION NUMBER (TIN) REQUIRED IT (FRN) (22) APPLICANT (TN) 0004959912 481247496 MPLETE SECTION C FOR EACH SERVICE, IF MORE BOXES ARE NEEDED, USE CONTINUATION SHEET GN/OTHER ID (24A) PAYMENT TYPE CODE |(25A) QUANTITY CUT ; FOR (PTC) (27A) TOTAL FEE FCC USE ONLY ' $815.00 DE 1 (29A) FCC CODE 2 GN/E)THER Ib ‘ (2;1B) PAYME;\IT TYPE CODE J (25B) QUANTITY . FOR (PTC) (27B) TOTAL FEE FCC USE ONLY DE 1 (29B) FCC CODE 2 SECTION D — CERTIFICATION ATION STATEMENT mea~d , certify under ty of perj foregoing"and supporting information is true and correct to nowledge, information and belief. SIGNATURE / DaATE_"‘7 =1 3. ~G j SECTION E — CREDIT CARD PAYMENT INFORMATION


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Document Modified: 2019-04-19 07:52:29
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