Local Number LOA

FracTEL Account Code*

Numbers will be transferred to this account

Customer Information

Customer Business Name*

Customer Business Name as it appears on current invoice

Customer Address*

This should be the service address shown on current providers invoice. Use billing address if it is the same.

Street Address 1 Street Address 2 City State ZIP Code

Contact Information

Authorized User*

This must be the name of the individual who is authorized by current provider to make changes to account and who will be signing Letter of Agency.

First Last

Authorized User Title*

Contact Email Address*

Contact Phone*

Telephone Number Information

Current Service Provider Name*

The name of your current carrier or service provider.

Account Number

Account number should be on your current providers invoice.

If your account has a PIN it should be on your current providers invoice.

Billing Telephone Number (BTN)*

If your account number is the same as one of your telephone numbers, enter it as BTN. Otherwise, enter your main number.

Is this a Partial Port?*

If you have numbers that will not be porting and will remain active with current provider, select YES.

Full
Partial

Is Billing Telephone Number (BTN) Porting?*

If port is partial, and BTN is porting, select YES.

NO
YES

New Billing Telephone Number (BTN)

Select a new BTN if partial port and current BTN is porting. This must be one of the numbers that will remain active with your current provider.

How many telephone numbers are you transferring?*

20 or less
More than 20

Enter VOICE numbers to be transferred below

Enter FAX numbers to be transferred below

IMPORTANT: If you are transferring more than 20 telephone numbers, please send a complete list via email to lnp@fractel.net to initiate your transfer.

Comments

This field is for validation purposes and should be left unchanged.

Local Number Transfer Authorization

Customer Information

Contact Information

Telephone Number Information