Carrier: (Exact legal title or name of the respondent) _______________________________
_______________________________
Name, title, telephone number and address of the person to be contacted:
Name _______________________________
Title _______________________________
Telephone Number: (Area Code) and (Telephone number) _______________________________
Office Address: (Street and number) (City, State, and ZIP code) _______________________________
_______________________________
certification
I, the undersigned, _______________________________
of (Title of officer in charge of accounts) _______________________________
_______________________________
(Full name of reporting company) _______________________________
certify that during the calendar year 19__ the branch line accounting system data were collected and maintained for each line that met the criteria set forth in 49 CFR 1201, Subpart B, section 920(a), Lines For Which Data Collection Is Required, (Docket No. 36366).
Signature _______________________________
Date______
The lines covered by this certification are described below: (Describe each branch line separately using the following format as set forth in 49 CFR 1152.11 .)
(a) Carrier's designation for line (Ex. Zanesville Secondary Track);
(b) State or states in which line is located;
(c) County or counties in which line is located;
(d) Milepost delineating each line or portion of line;
(e) Agency or terminal station(s) located on line or portion of line with milepost designations;
(f) Current category designation and date placed in that category; and
(g) Previous category.
49 C.F.R. §I to Part 1201