My Country Mobile — KYC Onboarding

Step 1 of 7

Company / Basic Information

Legal entity and registration details

Company Name *

DBA / Holding co. / Trading name

Company Type *

Incorporation Date *

Incorporation State / Country *

Business Registration # *

Tax ID / EIN / VAT / TIN *

Corporate / business names used in the past 3 years

List all DBAs, aliases and fictitious names, or 'N/A'.

Business Description

VoIP

Hosted PBX / UCaaS

International

Call Center

Wholesale Carrier

Other

Registered Address

Company Address *

Address Line 2

City

State / Province

Postal / Zip Code

Country *

Website

Social Media Profiles

Current & past IP addresses (last 3 years)

Requested Go-Live Date

Step 2 of 7

Regulatory IDs

US telecom identifiers & STIR/SHAKEN

FRN #

499 Filer ID

RMD #

OCN

STIR/SHAKEN Attestation Level *

Step 3 of 7

Contacts

Primary, billing, and role-based contacts

Main Contact

Main Contact *

Designation / Title *

Mobile Number *

Phone Number *

Email Address *

Teams ID

Billing

Billing contact same as main contact

Billing Contact Name

Billing Email

Billing Phone

Billing Address

Legal / Compliance Contact

Legal/Compliance Contact Name

Legal/Compliance Contact Email

Legal/Compliance Contact Phone

Step 4 of 7

Traffic Profile & Quality

Volume, capacity and quality metrics

Traffic Route *

Traffic Type *

Ports Requirement

CPS (Calls Per Second)

Concurrent Sessions

Expected monthly VoIP minutes

Typical Average Length of Call (ALOC)

Attempts-to-minutes ratio

Share of calls rejected

Answer-Seizure Ratio (ASR)

% of calls lasting 6 seconds or less

Gateway-provider status

Yes No

Foreign-service-provider status

Yes No

Listed in FCC's Intermediate Provider Registry?

Yes No

Rural Call Completion contact email

Safeguards to prevent fraud & robocalls

Step 6 of 7

Required Documents

PDF / JPG / PNG · max 10 MB each

EIN Certificate *

OCN Letter *

Articles of Incorporation / Certificate of Good Standing *

Address proof (utility bill / lease / bank statement)

FUSF Form

Completed FUSF form

Upload the completed FUSF form.

Step 7 of 7

Certification & Signature

Review and attest to the statements below

I agree to notify within 24 hours of any provider blocking. *

I agree to identify the source of illegal traffic on traceback requests. *

I screen my clients with KYC / downstream compliance questions. *

I certify knowledge of applicable telecom laws (TCPA, Truth in Caller ID Act, etc.). *

I commit to responding to traceback requests within 24 hours. *

I certify the information provided is true, complete and accurate, and I am authorised to bind the company. *

Customer / Company Name *

Print Name (signer) *

Title *

Date *

Signature *

Draw your signature using a mouse or touchscreen.