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["Connect America Phase II Challenge Process Form"]
["OMB Control Number 3060-0986"]
["FCC Form 505"]
["Filing Entity:"]
["FRN (if applicable):"]
["Name of Person Filling Out Form:"]
["Mailing Address of Person Filling Out Form:"]
["Email Address of Person Filling Out Form:"]
["Phone Number of Person Filling Out Form:"]
["Name of Person Certifying Data within Form:"]
["Mailing Address of Person Certifying Data within Form:"]
["Email Address of Person Certifying Data within Form:"]
["Phone Number of Person Certifying Data within Form:"]

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["Census Block 15 Digit FIPS Code","State","Provider Name As Listed in National Broadband Map","Insert X if Speed Criteria Not Met","Insert X if Usage Allowance Criteria Not Met","Insert X if Latency Criteria Not Met","Insert X if Price Criteria Not Met","Insert X if Voice Criteria Not Met","Type of Supporting Evidence","Additional Comments","OMB Control Number 3060-0986"]

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["Census Block 15 Digit FIPS Code","State","Name of Entity Providing Service","FRN used to File Form 477 (if challenge being filed by the service provider)","Insert an X if you certify that this census block is served by unsubsidized broadband and voice services meeting the Commission's performance and pricing criteria.","Type of Supporting Evidence","Additional Comments","OMB Control Number 3060-0986"]

{"sheet":"Response_to_Challenge","index":3,"n_rows":1,"n_cols":12,"rows_kept":1,"cut":false,"hidden":false,"merged":[],"flags":["formulas_cached_only"]}
["Census Block 15 Digit FIPS Code","State","Name of Entity Making Initial Challenge","FRN of Entity Making Initial Challenge (if provided)","Insert X if Speed Criteria is at Issue","Insert X if Usage Allowance Criteria is at Issue","Insert X if Latency Criteria is at Issue","Insert X if Price Criteria is at Issue","Insert X if Voice Criteria is at Issue","Type of Supporting Evidence","Additional Comments","OMB Control Number 3060-0986"]

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["OMB Control Number 3060-0986"]
[]
["Accuracy and Due Diligence Certification"]
["All Filers Must Fill Out"]
[]
["By initialing below, I certify that all statements contained in the  attached form are true and accurate to the best of my knowledge, and  that I have undertaken due diligence to obtain knowledge regarding these claims."]
[]
["Certifier's Initials:"]
["Date:"]
[]
[]
[]
["Notice of Challenge Certification"]
["(Served to Unserved and Unserved to Served Challengers Fill Out One of the Following Blocks - Respondents Do Not Fill Out)"]
["Service of Notice Successful"]
["By initialing below, I certify that notice of this challenge has been served on all interested parties."]
[]
["Certifier's Initials:"]
["Date:"]
["Service of Notice Unsuccessful"]
["By initialing below I certify that, following a good faith effort, I was unable to serve notice of this challenge on all interested parties due to lack of information regarding the address of such parties."]
[]
["Name of Party/Parties that Could Not Be Served:"]
["Certifier's Initials:"]
["Date:"]
[]
["The certifications on this page are subject to the penalties for false statements under 18 U.S.C. 1001."]