Cable Landing License Act 47 CFR 1.767; 1.768; Executive Order 10530

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Overview

Applicant(s)
PII
Owner (Entities)
Service Providers
Principal Equipment
Facilities
Other Third Parties with Access
Records & Content Locations
Foreign-based Access
Interconnecting & Peering
Underlying Carriers
Government Customers

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Sheet 1: Applicant(s)

New Cable Q1	New Cable Q1	New Cable Q1	New Cable Q1
Cable Transfer Q1	Cable Transfer Q1	Cable Transfer Q1	Cable Transfer Q1
Company Name	Business Address	Principal Place of Business	Place of Incorporation

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Sheet 2: PII

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34

New Cable Q3, Q10, Q34

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q3, Q10, Q34, Q37

New Cable Q34

New Cable Q34

New Cable Q3, Q10, Q34, Q37

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36

Cable Transfer Q3, Q11, Q36

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q3, Q11, Q36, Q39

Cable Transfer Q36

Cable Transfer Q36

Cable Transfer Q3, Q11, Q36, Q39

First Name

Last Name

Aliases

Company Name

Business Address (if applicable)

Country of Residence

City of Residence

State of Residence

Date of Birth (E.g. MM/DD/YYYY)

Place of Birth (E.g. State, Country)

SSN

Passport (Country)

Passport #

Citizenship

Additional Citizenship Countries

U.S. Lawful Permanent Resident (E.g. Yes/No)

Alien Number

Residence Address

Personal Cell Phone Number

Business Phone Number

Home Phone Number

Company Role/Title and/or Ownership %

Type of Access (E.g. Read or Read/Write)

Access to: (Pick: Physical Facilities/Equipment; Customer Records; Network/Monitoring/Audit Features; Electronic Interfaces?)

Triage Question (Pick all that apply: Owners; Officers; Foreign Access; LEPOC)

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Sheet 3: Owner (Entities)

New Cable Q3	New Cable Q3	New Cable Q3	New Cable Q3	New Cable Q3	New Cable Q3	New Cable Q3	New Cable Q3
Cable Transfer Q3	Cable Transfer Q3	Cable Transfer Q3	Cable Transfer Q3	Cable Transfer Q3	Cable Transfer Q3	Cable Transfer Q3	Cable Transfer Q3
Company Name	Business Address	Foreign Entity or Foreign-Government controlled Entity?	Country of Incorporation (if United States, include state of incorporation)	Principal Place of Business	General Business Type (e.g., holding company, investment firm, etc.)	Email Addresses	Phone Numbers

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Sheet 4: Service Providers

New Cable Q25, 27, 30, 44	New Cable Q25, 27, 30, 44	New Cable Q25, 27, 30, 44	New Cable Q25, 27, 30, 44	New Cable Q25, 27, 30, 44	New Cable Q25, 27, 30, 44	New Cable Q30	New Cable Q30
Cable Transfer Q27, 29, 32, 46	Cable Transfer Q27, 29, 32, 46	Cable Transfer Q27, 29, 32, 46	Cable Transfer Q27, 29, 32, 46	Cable Transfer Q27, 29, 32, 46	Cable Transfer Q27, 29, 32, 46	Cable Transfer Q27, 29, 32, 46	Cable Transfer Q27, 29, 32, 46
Company Name	Business Address	Country of Incorporation	Principal Place of Business	General Business Type (e.g., holding company, investment firm, etc.)	Phone Numbers	Does the company have remote Access/monitoring to the cable network, systems, or records?	If Access is given, what is the role of the company and the reason for Access?

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Sheet 5: Principal Equipment

New Cable Q26, 46	New Cable Q26, 46	New Cable Q26, 46	New Cable Q26, 46
Cable Transfer Q28, 49	Cable Transfer Q28, 49	Cable Transfer Q28, 49	Cable Transfer Q28, 49
Company Name	Model	Version Number	Functions Supported

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Sheet 6: Facilities

New Cable Q24	New Cable Q24	New Cable Q24	New Cable Q24	New Cable Q24
Cable Transfer Q26	Cable Transfer Q26	Cable Transfer Q26	Cable Transfer Q26	Cable Transfer Q26
Company Name	Address of Facility	Facility Type (e.g., CLS, NOC, Back-Up NOC, Data Center, Distribution Facility, POP)	Existing or New Facility?	Information on any party sharing the facility or equipment

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Sheet 7: Other Third Parties with Access

New Cable Q30	New Cable Q30	New Cable Q30
Cable Transfer Q32	Cable Transfer Q32	Cable Transfer Q32
Company Name	Remote Access/monitoring to the network, systems, or records?	What is the role of the company and the reason for Access?

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Sheet 8: Records & Content Locations

New Cable Q35(b)	New Cable Q35(b)	New Cable Q35(c)
Transfer Cable Q37(b)	Transfer Cable Q37(b)	Transfer Cable Q37(c)
Addresses of locations where records will be stored	Storage Location Countries	Purpose of Location and Function within Applicant System

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Sheet 9: Foreign-based Access

	New Cable Q35(b),(d)	New Cable Q35(b),(d)	New Cable Q35(b),(d)
	Transfer Cable Q37(b), (d)	Transfer Cable Q37(b), (d)	Transfer Cable Q37(b), (d)
Company Name	Addresses of locations where records will be remotely accessed/managed via electronic systems	Countries from which U.S. Records can be Remotely Accessed/Managed	How are U.S. Records Remotely Accessed?

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Sheet 10: Interconnecting & Peering

New Cable 41	New Cable 41
Cable Transfer Q43	Cable Transfer Q43
Company Name	Details

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Sheet 11: Underlying Carriers

New Cable Q41	New Cable 41
Cable Transfer Q44	Cable Transfer Q43
Company Name	Details

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Sheet 12: Government Customers

New Cable Q28	New Cable Q28	New Cable Q28
Cable Transfer Q30	Cable Transfer Q30	Cable Transfer Q30
Government Customer Name	Federal, State, or Local Government?	Services Provided