SECTION II. Existing 800/888/877/866 Transfers to TouchTone
Submit by E-mail
Print Form
TOLL FREE LOA & APPOINTMENT OF RESPONSIBLE ORGANIZATION New Order
Re-Submit
NASC ($40 per Toll Free)
SECTION I. Contact Information Account Name: _______________________________________________________________________________________ Mailing Address: _______________________________________ Apt./Suite: _____________________________________ City: _________________________________________________ State: ________________
Zip: ___________________
Contact Name: _________________________________________ Phone: ________________________________________ SECTION II. Existing 800/888/877/866 Transfers to TouchTone Service Toll Free Number to Transfer
Destination (Ring To) Number
Account No.
Existing Carrier
1 2 3 *Please attach any additional Transfer Numbers to this form.
SECTION III. New 800/888/877/866 Numbers Destination (Ring To) Number: ________________________________ (required) First Choice (Vanity Number): _______________________________
Previously Reserved
Yes
Second Choice (Vanity Number): _____________________________ PLEASE NOTE: If the numbers listed above are not available, TouchTone will choose a number on behalf of the Customer.
SECTION IV. Access Restriction NPA/Area Code: ________________________________________
Block
Allow Only
NPA/NXX: first 6 digits of a 10-digit North American phone number ____________________
Block
Allow Only
State Restriction: to place a restriction on all inbound calls from a particular state _________________________ Extended Coverage: inbound calls from Alaska, Hawaii, Canada, the Caribbean, and Puerto Rico Payphone Calls
Block
Allow
Directory Assistance
Restrict calls made from a prison, penitentiary, or correctional facility?
Yes
Block
Block
Allow Only
Allow
(If yes, Directory Assistance Form req'd)
Yes
No
Other/Special Instructions: _____________________________________________________________________________ My signature below authorizes TouchTone Communications to act as my Agent in all matters related to providing and managing 800/888/877/866 long distance service for the company. In particular, but not limited to, authorization to act as the Responsible Organization, to select and change choice of the transport carrier, and to obtain information relating to my account from any local exchange or long distance telephone provider. TouchTone will utilize our underlying Carrier's RespOrg ID (LGT01) or ATL Telecom Services (AUA37) as the RespOrg for your 8XX numbers. By signing below I also confirm that I have signed and agreed to all of the Terms and Conditions listed in the Standard Service Agreement and on www.touchtone.net, both which may be modified from time to time.
Authorized Signature: __________________________________________________________
Date: _______________
AGENCY INFORMATION TouchTone BTN______________________________________ TouchTone NASC Approval________________________ Agent ID___________________ Agent Phone____________________ INTER_______________ INTRA_______________ ATL (TouchTone) RespOrg ID: AUA37 ATL RespOrg Telephone: 541-593-2900 ATL RespOrg Fax: 541-593-2090 Fax completed form to 1-800-266-4011, or e-mail a scanned copy to [email protected]. Questions? Call Customer Service at 1-800-266-4006
Print Form
TOLL FREE LOA & APPOINTMENT OF RESPONSIBLE ORGANIZATION New Order
Re-Submit
NASC ($40 per Toll Free)
SECTION I. Contact Information Account Name: _______________________________________________________________________________________ Mailing Address: _______________________________________ Apt./Suite: _____________________________________ City: _________________________________________________ State: ________________
Zip: ___________________
Contact Name: _________________________________________ Phone: ________________________________________ SECTION II. Existing 800/888/877/866 Transfers to TouchTone Service Toll Free Number to Transfer
Destination (Ring To) Number
Account No.
Existing Carrier
1 2 3 *Please attach any additional Transfer Numbers to this form.
SECTION III. New 800/888/877/866 Numbers Destination (Ring To) Number: ________________________________ (required) First Choice (Vanity Number): _______________________________
Previously Reserved
Yes
Second Choice (Vanity Number): _____________________________ PLEASE NOTE: If the numbers listed above are not available, TouchTone will choose a number on behalf of the Customer.
SECTION IV. Access Restriction NPA/Area Code: ________________________________________
Block
Allow Only
NPA/NXX: first 6 digits of a 10-digit North American phone number ____________________
Block
Allow Only
State Restriction: to place a restriction on all inbound calls from a particular state _________________________ Extended Coverage: inbound calls from Alaska, Hawaii, Canada, the Caribbean, and Puerto Rico Payphone Calls
Block
Allow
Directory Assistance
Restrict calls made from a prison, penitentiary, or correctional facility?
Yes
Block
Block
Allow Only
Allow
(If yes, Directory Assistance Form req'd)
Yes
No
Other/Special Instructions: _____________________________________________________________________________ My signature below authorizes TouchTone Communications to act as my Agent in all matters related to providing and managing 800/888/877/866 long distance service for the company. In particular, but not limited to, authorization to act as the Responsible Organization, to select and change choice of the transport carrier, and to obtain information relating to my account from any local exchange or long distance telephone provider. TouchTone will utilize our underlying Carrier's RespOrg ID (LGT01) or ATL Telecom Services (AUA37) as the RespOrg for your 8XX numbers. By signing below I also confirm that I have signed and agreed to all of the Terms and Conditions listed in the Standard Service Agreement and on www.touchtone.net, both which may be modified from time to time.
Authorized Signature: __________________________________________________________
Date: _______________
AGENCY INFORMATION TouchTone BTN______________________________________ TouchTone NASC Approval________________________ Agent ID___________________ Agent Phone____________________ INTER_______________ INTRA_______________ ATL (TouchTone) RespOrg ID: AUA37 ATL RespOrg Telephone: 541-593-2900 ATL RespOrg Fax: 541-593-2090 Fax completed form to 1-800-266-4011, or e-mail a scanned copy to [email protected]. Questions? Call Customer Service at 1-800-266-4006
