BEFORE THE CORPORATION COMMISSION OF THE STATE OF OKLAHOMA

NOTICE AND FILING OF INTRASTATE ) CAUSE NO. PUD ______

TARIFF REVISIONS TO (Tariff No. )

or Service) TARIFF BY (Place Name of Company here) )

NOTICE AND FILING OF REVISIONS TO

(Name of Company) COMPANY'S OKLAHOMA CORPORATION COMMISSION

(Tariff No. or Service) TARIFF

______________________________________________________

1. PARTIES AND INTERESTS

(Here list the name of the company whose tariff is being revised, the source of authority to provide services in Oklahoma (i.e., certificate order number), the address of the company and a statement as to what other parties may be interested in the revisions; e.g., other certificated service providers.)

2. FACTS

(Here describe the proposed revisions to the tariff including, but not limited to, the name of the service affected, a listing of the pages to be affected by the proposed change, the purpose of the proposed revisions, whether the proposed revisions will increase or decrease rates for existing customers, and whether the service is a new or restructured service.)

3. LEGAL AUTHORITY

Jurisdiction over the subject matter of this Notice and Filing exists with the Oklahoma Corporation Commission by virtue of Article IX, Section 18 of the Oklahoma State Constitution and by Commission Order No. (granting certificate of convenience and necessity to the company), issued in Cause No. __________ on (date). This Notice and Filing is also authorized by (insert citation here – resold toll service: OAC 165:56-5-__, or – local exchange or interexchange service: OAC 165:55-5-__,) et seq.

4. STATEMENT OF COMPLIANCE

(Name of Company) will cause a copy of the Notice and Filing of Intrastate Tariff Revisions to be mailed directly to the Public Utility Division of the Oklahoma Corporatoin Commission and the Attorney General of the State of Oklahoma as shown on the attached Certificate of Mailing.

5. RELIEF REQUESTED

WHEREFORE, Applicant respectfully requests that the Commission permit the proposed tariff revisions to become effective without hearing after (insert the appropriate number of days pursuant to the authorization cited above, for example: thirty (30)) days notice.

Respectfully submitted,

________________________________________

(Signature)

________________________________________

(Printed name of signer and title)

(Company name, address and telephone number)

[Source: Added at 12 Ok Reg 2147, eff 7-1-95; Amended 14 Ok Reg 2855, eff 7-15-97]