Application Form

This document pretains to SPC-NEW-20170701-00008 for New Application on a Signaling Point Code filing.

INTERNATIONAL SIGNALLING POINT CODE FILING PER NETWORK PER CODE

APPLICANT INFORMATION

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

Hideyo Noguchi jpy

1. Applicant Name: NIELLO BMW Phone Number: 4134091671 DBA Name: Fax Number: United States Street: 2020 Fulton Ave E-Mail: [email protected] City: Sacramento State: CA Country: USA Zipcode: 95825 - 9582 Attention:

2. Contact Name: Marie Davis Phone Number: 4134091671 Company: BMoH Fax Number: Street: 1015 LONGWORTH HOUSE OFFICE BU E-Mail: City: Washington State: Country: USA Zipcode: - Attention: Relationship:

3. Network Location: Please supply any needed attachments Attachment 1: Hideyo Noguchi Attachment 2: Hideyo Noguchi Attachment 3: City: Sacramento State: CA Estimated Implemention Date:

4. Code assignments held in excess of 12 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

5. I am aware that all ISPC assignments are provisional and that nobody has a property right in a ISPC. I am aware that the Commision may take an assigned ISPC and reassign it to another person. Yes No

6. I am aware that once a carrier has been granted its signalling point code, it must file annual International Traffic Data Reports (Section 43.61), which are due only July 31 each year, and the annual Circuit Status Reports (Section 43.82), whcih are due on March 31 each year. Unless a carrier that has been granted a point code has notified this office that it has nothing to report, its failure to file either of these reports will be interpreted as inactive operation and could, therefore, result in the loss of the carrier's point code assignment. Yes No

7. Are you a current holder of a 214 license (international telecommunication common carrier)? If yes, enter the 214 file number: NO If no, please explain:

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).

FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT The public reporting for this collection of information is estimated to average less than 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the required data, 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 (3060-1028), 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 3060-1028. THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW 104-13, OCTOBER 1, 1 995, 44 U.S.C. SECTION 3507.