Letter of Authorization

Created January 23, 2019

Current Provider Customer Information
Date
MM slash DD slash YYYY
1. Authorized Signer
Full Name*
First Last
Title
Email*
Phone
2. Billing Contact (required if different than Authorized Signer
Name
First Last
Title
Phone
3. Billing Address
Company Name*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
4. Service Address (required if different than Authorized Signer
Company Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number Porting Details
Desired port due date (Must be no less than 7 business days. Your transfer is NOT guaranteed to be on this date)
Desired Port Date*
MM slash DD slash YYYY
Current Service Provider*
Account Number (sometimes called a BTN)*
Account PIN (If Applicable)
Depending on the losing carrier, you may have to request a Port Out PIN. In these cases your standard PIN will not allow the port. (Contact the losing carrier to determine if this applies to your port request)
Type Of Numbers*
- Voice Numbers
- Toll Free Numbers
- Fax Numbers
Phone numbers to transfer*
Please list all phone numbers to be transferred below (separate each new phone number on a new line). Fax Numbers MUST be submitted on a separate LOA and marked as FAX numbers. Toll-Free numbers must be separate too
Partial Port*
Partial Ports are ports that are not pulling every number off your account from the losing carrier. This includes Fax, Internet, and Phone numbers being left on the losing carrier account.
New Account BTN (NBTN) after Port
Billing Telephone Number "BTN" left on the losing carrier account during a partial port. The losing carrier will have this information if you do not have this readily available. "If the losing carrier is AT&T or a sub contracted account through AT&T with internet, please contact their customer service for the new BTN"
Upload Current Copy of CSR (Customer Service Record)
Accepted file types: jpg, jpeg, gif, png, pdf, tiff, Max. file size: 128 MB.
Please use this button to upload your MOST CURRENT copy of your telephone bill. This bill MUST not be older than 30 days or your port could be rejected. A CSR stands for "Customer Service Record" and must be requested from the losing carrier.
- Please include a copy of your last bill with this Letter of Authorization
- Ensure all information matches EXACTLY what your current provider has on file now. DO NOT provide new service information
- Do NOT call your current provider to cancel your service or you will not be able to keep your number
- We will contact you via email or a service ticket when a number transfer date has been scheduled
- When your numbers transfer to [reseller]'s Telco Network it will ring to your Voice Service
- When you number transfer is complete you should then contact your old provider to ensure the old services are cancelled
- Please ensure all forms are fully complete
Submitted from IP address 172.69.59.34

Letter of Authorization

Letter of Authorization

Current Provider Customer Information

1. Authorized Signer

2. Billing Contact (required if different than Authorized Signer

3. Billing Address

4. Service Address (required if different than Authorized Signer

Phone Number Porting Details