Application Form [pdf]

This document pretains to ITC-214-20161026-00289 for International Global Resale Authority on a International Telecommunications filing.

IBFS_ITC2142016102600289_1156955

                                                                                                                 Approved by OMB
                                                                                                                        3060−0686
                                          INTERNATIONAL SECTION 214 APPLICATION
                                                             FCC FORM 214
                                                   FOR OFFICIAL USE ONLY

  APPLICANT INFORMATION
Enter a description of this application to identify it on the main menu:
Application for Authority to Provide Global or Limited Global Resale Authority to All International Points Except Cuba
1. Applicant

           Name:        Lightspeed Telecom LLC          Phone Number:                   618−548−8484

           DBA                                          Fax Number:                     618−548−3491
           Name:
           Street:      123 E. Main St.                 E−Mail:                         sandrews@ussonet.net


           City:        Salem                           State:                          IL
           Country:     USA                             Zipcode:                        62881        −
           Attention:   Susan Andrews




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2. Contact

             Name:        Lightspeed Telecom LLC            Phone Number:               618−548−8484
             Company:                                       Fax Number:                 618−548−3491
             Street:      123 E. Main St.                   E−Mail:                     sandrews@ussonet.net


             City:        Salem                             State:                      IL
             Country:     USA                               Zipcode:                    62881    −
             Attention:                                     Relationship:



3. Place of Incorporation of Applicant
4. Other Company(ies) and Place(s) of Incorporation



5. Service Type(s) (check all that apply)
       Global or Limited Global Facilities−Based Authority (Section 63.18(e)(1))
      Global or Limited Global Resale Authority (Section 63.18(e)(2))
      Individual Facilities−Based Service (Section 63.18(e)(3))
      Individual Switched Resale Service (Section 63.18(e)(3))
      Individual Facilities−Based and Resale Service (Section 63.18(e)(3))
      Switched Services over Private Lines (ISR) (Section 63.16 and/or 63.18 (e)(3))
      Inmarsat and Mobile Satellite Service (Section 63.18(e)(3))
      Overseas Cable Construction (Section 63.18(e)(3))
      Individual Non−Interconnected Private Line Resale Service (Section 63.18(e)(3))
      Other (Section 63.18(e)(3))


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6a. Is a fee submitted with this application?
     If Yes, complete and attach FCC Form 159.    If No, indicate reason for fee exemption (see 47 C.F.R.Section 1.1114).
    Governmental Entity         Noncommercial educational licensee
    Other(please explain):

6b. Fee Classification    CUT − Section 214 Authority
7. Destination Country(ies) (e.g., "Country X", "All international points", "All international points except Country X and Country Y" or
"Countries X, Y, and Z only".)     All


8. Caption (description of authority requested, e.g., Application for Authority to Provide International Facilities−Based and Resold Services to
All International Points Except Country X)
   (If the complete description does not appear in this box, please go to the end of the form to view it in its entirety.)
                    Application for Authority to Provide Global or Limited Global Resale
                    Authority to All International Points Except Cuba




9. Does the applicant request streamlined processing pursuant to 47 C.F.R. Section 63.12? If yes, include in               Yes             No
Attachment 1 a statement of how the application qualifies for streamlined processing.


10. If applying for authority to provide switched services over private lines pursuant to Section 63.16, provide the required showing in
Attachment 1.




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Applicant certifies that its responses to questions 11 through 17 are true:

 11. If the applicant is a foreign carrier, or is affiliated (as defined in 47 C.F.R. Section 63.09(e)) with a foreign
 carrier, provide in Attachment 1 the information and certifications required by Section 63.18(i) through (m).



 12. Does the applicant seek authority to provide service to any destination described in paragraphs (1) through (4)     Yes   No
 of Section 63.18(j)? If yes, list those destinations in Attachment 1 as a response to question 12.




 13. Does the applicant seek authority to provide service to any destinations other than those listed in response to     Yes   No
 question 12 where it has an affiliation with a foreign carrier? If yes, list those destinations in Attachment 1 as a
 response to question 13.




 14. [Section 63.18(h)] In Attachment 2, provide the name, address, citizenship and principal business of the
 applicant’s ten percent or greater direct and indirect shareholders or other equity holders, and identify any
 interlocking directorates.



 15. In Attachment 2, respond to paragraphs (d), (e)(3) and (g) of Section 63.18.




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16. By checking Yes, the undersigned certifies that neither applicant nor any other party to the application is subject    Yes   No
to a denial of Federal benefits that includes FCC benefits pursuant to Section 5301 of the Anti−Drug Act of 1988,
21 U.S.C. Section 862, because of a conviction for possession or distribution of a controlled substance. See 47
CFR 1.2002(b) for the meaning of "party to the application" for these purposes.



17. By checking Yes, the applicant certifies that it has not agreed to accept special concessions directly or indirectly   Yes   No
from a foreign carrier with respect to any U.S. international route where the foreign carrier possesses sufficient
market power on the foreign end of the route to affect competition adversely in the U.S. market and will not enter
into such agreements in the future.



CERTIFICATION
18. Typed Name of Person Signing (Must be a Corporate Officer)              19. Title of Person Signing
Susan J. Andrews                                                            Susan J. Andrews
          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).


        20. 1:     Attachment 1                       2:     Attachment 2                          3:




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Remember − You are not required to respond to a collection of information sponsored by the Federal government, and the government may not
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collection has been assigned an OMB control number of 3060−0686.

THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW 104−13, OCTOBER
1, 1995, 44 U.S.C. SECTION 3507.




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Document Created: 2019-04-19 23:14:50
Document Modified: 2019-04-19 23:14:50

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