Professional Documents
Culture Documents
DIDPort Form
DIDPort Form
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Billing Name of Customer as shown on existing Telephone Company Equipment Record
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Billing Address of Customer as shown on Telephone Company Equipment Record
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Local Service Address if different from above
Last four digits of social security number (in case of wireless line):
Authorized by
Name (Printed):
Title/Position:
Signature:
Date:
Telephone Number(s):