Local Number Porting Letter of Authorization-Colquitt Connect Net

Local Number Porting Letter of Authorization

By signing this letter, you authorize City Of Colquitt Communications to communicate with your current telephone provider in an effort to port your number(s). Please fill in the required information below regarding your account with your CURRENT phone service provider. Refer to your current phone bill, or contact your current service provider if necessary.

Account #

Account Billing Name

Bill to Number (BTN)

Type of Account:

First Name

Last Name

Service Address: (Must reflect the SERVICE address on record with your current phone company.

Numbers to be ported (10 digits each, attach additional list if necessary):

Please note: A separate "Letter of Authorization" is required for each account if you are moving local numbers from multiple accounts with the same phone service provider or different providers)

By signing below, I confirm that all information is accurate and that I have checked with my current provider that NO NUMBER LISTED ABOVE HAS DSL OR ALARMS SYSTEMS ASSOCIATED WITH IT.

Your Signature

Name:

Company

Effective Date:

Upload File Copy of Bill

Note: Your current phone service provider will not allow the port of your numbers to the City of Colquitt without an authorized signature from an account owner or administrator shown in their records for this account. By filling in the Signature field above, you agree to use an electronic document and an electronic signature. You understand electronic signatures are legally binding in the United States and other countries. A faxed copy of the signature will be considered an original.

Please return a completed form with a copy of your current service provider's MOST RECENT telephone bill to the contact information below.