N.Y. Comp. Codes R. & Regs. Tit. 16 §§ 720-7.5
Tp. 2 No. ________
Cancels Tp. 2 No. ________
_______________
(Name of Public Utility)
Public Service Commission (Date) ________
3 Empire State Plaza
Albany, New York 12223-1350
This is to certify that the (name of telephone corporation)[FN1] assents to and concurs in the publication and filing of (rate schedule described below) [FN2] (any joint schedule) and revisions thereto which the (name of telephone corporation) may make and file, in which it is shown as a participating corporation, and hereby makes itself a party thereto and bound thereby insofar as such schedule contains joint rates, charges, rules, or regulations applying to communication by telephone (in any way involving use of its toll lines),[FN3] until this authority is revoked by formal and official notice of revocation filed with the Public Service Commission, State of New York, and with the telephone corporation to which this concurrence is given.
Title and No.: ________
Date of Issue: ________
Date Effective: ________
____________
(Name of Corporation)
By
____________
(Signature of Officer)
____________
(Title of Officer)
[FN1] If concurrence is given by one telephone corporation for itself, and also under power of attorney for other telephone corporations, it will be necessary to specify the names of all corporations for which concurrence is given.
[FN2] Strike out phrase not applicable.
[FN3] If the telephone corporation issuing concurrence does not desire to give such broad authority as "in any way involving the use of its toll lines," the concurrence may be modified to confer exactly the authority to be granted.
N.Y. Comp. Codes R. & Regs. Tit. 16 §§ 720-7.5