Please PRINT clearly!
1 - Physical Address of Service:
List the actual physical
address where service is to be provided. (If this is also the address where
invoices are to be mailed, then you do not need to fill out section 2). Please
indicate whether the account is residential or business and include a contact
name for all business accounts.
2- Billing Location:
Complete this section only if
invoices are to be mailed to a different address than the one listed in section
1.
3- Types of Service:
-
Switched (1+) service is the
standard type of service for residential and most business customers.
-
Please confirm your understanding
that both Inter-State & Intra-State service will be switched by checking both of these
boxes (Be sure to fill in the appropriate Intra-Rate for your state of
residence.)
Also indicate whether or not you want to switch your IntraLATA service (Regional / Local Toll) by circling either "Yes" or "No."
-
If you currently have a toll
free number, or would like a new toll free number, please check the Toll Free
Service box and submit a completed and signed
Toll Free Service Agreement in
addition to the Standard Service Agreement.
-
Dedicated Service (T1)
requires the completion of a
Dedicated Order Form. NOTE: Dedicated Service is normally appropriate only
when usage exceeds 35,000 minutes per month.
-
If you would like calling
cards, please mark the box and indicate the number of cards desired.
-
It is required that you
indicate if the lines listed on the Service Agreement are Residential lines,
Business lines, or Payphone lines.
-
It is also required that you
indicate your current average monthly billing for long distance service.
-
Please be sure to indicate the
name of your local telephone company.
4 - Telephone Numbers:
List your main
telephone number and all additional numbers. (It is very
important that we have all the numbers you wish to have switched in order to
ensure service and proper billing.) If you have more than 10 phone
numbers you should use the Additional
ANIs Form to list the extra numbers.
5 - Agency and Authorization:
Be sure to sign and date the Service
Agreement.
Please fax form(s) to:
1-888-758-2600
If you do not have a fax
machine, mail form(s) to:
TouchTone
3704 Wakefield Drive
Columbia, MO 65203
ACCOUNTING CODES: Business
customers requiring Accounting Codes will also need to complete the
Account Code Request Form.
IMPORTANT
Applicants with usage of more than $500 per month and/or more than 10 lines will
need to complete a Credit Application.
