Specifications

61200624L1-1A © 2002 ADTRAN, Inc. 9
I agree to provide ______________________ (telco’s name) with proper documentation to
demonstrate compliance with the information as provided in the preceding paragraph, if so
requested.
_________________________________Signature
_________________________________Title
_________________________________ Date
Transcribed and sworn to before me
This ________ day of _______________, _______
_________________________________
Notary Public
My commission expires:
_________________________________