Nationwide Local Copper/POTS Lines

Company Name:
* Service Location: Street Address:
* Service Address: City:
* Service Address: State:
* Servie Address: Zip Code:
* Service Address: Phone Number:
* Contact Person: Name:
* Contact person: Email Address:
* Contact person: Phone Number:
How many locations do you have?:
Please estimate how many POTS lines in total?:
Who is the current Local POTS Line Provider?:	Verizon Bell South SBC Qwest (USWest) ILEC (smaller incumbent local exhange carrier) CLEC (competetive local exchange carrier)
If you are on a CLEC or ILEC please identify who the local carrier is?:
Would you like to consolidate your billing for all lines onto one bill?:	YES NO
What Term Plan will you sign?:	3 Year 2 Year 1 Year Month to Month
Comments:

Nationwide Local Copper/POTS Lines