Powernet Global RESPORG after setting up your account with Powernet Global 866.321.5452

1. Select Print, 2. Complete and Sign 3. Fax to Powernet Global
 


IMPORTANT: Please See Note Below For Transferring A Toll Free Number Only

Customer Information

Customer Name________________________________________________________________

Account Name (exactly as it appears on your current toll-free bill)_____________________________________

To insure proper transfer of your existing toll-free number, please attach the front page of the telephone bill from your current toll-free carrier.

Street Address (as it appears on your current phone bill)_____________________________________

City___________________________________   State_____________   Zip Code__________________

*Mailing / Billing Address (if different)________________________________________________

City___________________________________   State_____________   Zip Code__________________

Toll-Free Numbers to be Transferred
I, the undersigned, hereby authorize PowerNet Global Communications to act as my agent for the following toll-free numbers(s):
Toll-Free Number(s) Ring-To Number(s) Current Carrier Switched Dedicated
(____)_____-________ (____)_____-________ ________   ____   ____
(____)_____-________ (____)_____-________ ________   ____   ____
(____)_____-________ (____)_____-________ ________   ____   ____
(____)_____-________ (____)_____-________ ________   ____   ____
Agreement and Waiver
  • The undersigned is not an agent for any third party.
  • The undersigned represents and warrants that they are the exclusive end user/subscriber of the toll-free number(s) listed herein.
  • The undersigned authorizes PNG Telecommunications, Inc. as agent for the appointment of responsible organization for the toll-free number(s) listed herein.

I understand and agree with the above information:

Authorized Customer Signature______________________________________   Date ____/_____/______

Printed Name_______________________________________________________________________

Agent ID:LDU5381212
Your Account # LDU5381212_
 Long Distance USA, LLC		 | Fax this form to 1-877-876--2943
or 1 888-715-3534 AFTER  You Signup online
or Signup at the Call Center 866.321.5452  or already have an account with Powernet Global Communications

 

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