The undersigned customer ("Customer") hereby appoints Telocall to act as its authorized agent for all matters pertaining to the 8YY services listed above. This agency includes the ordering of rearrangement of services, assignment to primary carrier services requests, disconnection of service, and other requests as deemed necessary by Telocall to implement the 8YY services ordered from Telocall and itemized on Customer's Service Order Form(s) and associated attachments. This authorization will expire upon written notification.

    Billing Information

    Account Information

    Attachment A

    List all telephone numbers to be ported separated by commas. Do not add Local numbers to this RESPORG. Use a LOA for Local numbers.

    All Telephone Numbers: *

    Upload your bill:

    Authorized Signature: *

    Print Name: *

    (please print)

    Email Address: *

    (used for RESPORG updates)

    Date: *