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Letter of Authorization

I hereby acknowledge that I have the legal authority to authorize, and warrant that I am free of any third-party obligation preventing me from authorizing, Westelcom, and/or its subsidiaries and/or authorized agents to make any and all inquiries necessary for the purpose of obtaining Customer Service Records information. 

  Furthermore, I hereby acknowledge that I have the legal authority to authorize, and warrant that I am free of any third-party obligation preventing me from authorizing, Westelcom, and/or its subsidiaries and/or authorized agents to act as my agent for the purpose of TAKING ANY AND ALL ACTIONS REQUIRED (including the removal of any account protection/freezes) required to implement the LOCAL, INTRALATA, INTRASTATE, INTERSTATE, INTERNATIONAL LONG DISTANCE, and/or other services described herein for all my physical service and billing locations as noted on this form, including changing my long distance carrier(s) and/ or my local exchange carrier(s) to Westelcom from my current carrier(s).  I authorize Westelcom to use my CPNI to review my account information, assess current services and to assist me in making modifications to my account now and throughout the duration of my agreement with Westelcom.  I authorize Westelcom to notify all appropriate parties, including my current local and/or long distance telephone company(s), of this choice, and to make the necessary changes for my current and future services without further permission.  I direct my chosen intralata and/or intrastate/interstate/international long distance company(s), if not Westelcom, to comply with Westelcom’s current applicable access tariff(s), or release me from any unfulfilled contractual obligations for service.  Westelcom may obtain any records from my local intralata long distance, and/or intrastate/interstate/international long distance phone company(s) necessary to provide these services.  All statements made herein are true and accurate to the best of my knowledge. I hereby indemnify Westelcom, its employees, and agents, from any liability resulting from any credit inquiry, CPNI or Client privacy issue, or liability to any third-party for pre-existing obligations I may have regarding my local, intralata, intrastate, interstate, international long distance services.

Company Name

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Your Address

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By submitting this form, I authorize Westelcom to become my provider for phone service, long distance, and Internet or DSL service.  I verify that I am at least 18 years of age and in charge of all phone service decisions.