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The Customer hereby
authorizes DataNetNow to act on behalf of the Customer to make
changes to the Customer's existing local phone service with respect to Local
Number Portability, limited to the numbers listed below. The Customer hereby
authorizes DataNetNow to port/disconnect the
indicated local telephone numbers from the Customer's existing local phone
service provider.
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BILLING INFORMATION |
VERY IMPORTANT : PRINT VERY CAREFULLY OR THE FORM WILL BE REJECTED
SITE INFORMATION |
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Customer Trading / Operating Name |
Site 1 Address (include suite, floor unit) |
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Customer Name (as it
appears on the local phone bill if different) |
Site 2 Address (include suite, floor unit) |
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Company/Personal Address |
Site 2 Address (include suite, floor unit) |
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City |
Prov/State |
Postal Code |
Site 4 Address (include suite, floor unit) |
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CUSTOMER TELEPHONE NUMBERS
TO BE PORTED TO DATANETNOW.
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(ranges of numbers
are acceptable - consecutive numbers only) |
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Current Provider Name |
Telephone Number |
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Name of Signatory |
Title |
Date |
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