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Linuro
New Service Order Form

Thank you for choosing VoIP Tel, LP or its underlying service providers for your Telephone & PBX services. Please fill in the required information below regarding your need and requirements for new services.

Account Number:
Company Name:
Service Address:
Office/Suite No:
City:
State:
Zip:
Billing Address:
Office/Suite No:
City:
State:
Zip:
Requested Service Date:
 (Minimum of 10 working days are required)
Phone Lines QTY:
New Service:
 (Will require LOA to Port-In Numbers)
eFax QTY:
New Service:
 (Will require LOA to Port-In Numbers)
Dedicated Fax-to-Fax QTY:
New Service:
 (Will require LOA to Port-In Numbers)
Terms, Limitations & Usages of Requested Services

1. This order is for VoIP Voice Services only and requires High Speed Internet Connection to work.
2. This order does NOT automatically initiates or place an order for Data/Internet Connection (DSL, Cable Internet, or Fiber etc) unless Customer has shown interest in obtaining such services and has signed separate service order for such services. Otherwise it’s Customer’s responsibility to maintain an acceptable bandwidth/Data Connection for VoIP Services to work.
3. This VoIP service will only support *Voice* application and will not support Fax, security alarms, ATM Machines, Credit Card machines etc or any such other devices or services which requires Analog line dialer or modem.
4. Separate Fax to Email, Dedicated Fax or Internet services are available at very competitive rates, please inquire.
5. Customer agrees to standard 2 year Service Term.

By signing below, I agree and understand the terms, conditions, limitations and usages of requested services from VoIP Tel, LP and I verify that I represent above mentioned business and am fully authorized to purchase services and sign contract on behalf of the said business.


Company Legal Name:
Authorized Signature:
FEIN or Tax ID#:
Name:
Title:
Email Address:
Contact Number:
Executed effective as of this date: