CPNI FORM

Effective in December 2007, the FCC implemented new rules to protect the privacy of information contained in all telephone accounts, including your telephone account with Panora Fiber. The new rules allow us to discuss account information only with the person(s) listed on the account. We must also be able to confirm a caller is who they say they are.

We will confirm the identity of callers by asking them to answer the "authentication question listed below. Certain call detail information we will not share over the telephone regardless of authentication Instead that information will be mailed to you or we may call you back at the phone number on your account or you may stop into our office to pick up this call detail information.

You can add necessary persons to your account as "Authorized Contacts.' Those persons can discuss information and make changes to your account. Authorized Contacts will not be responsible for payment of your account.

Please type your answers to the question below. 

Each additional authorized contact to be listed on your account (if any) can be listed below your answer.

If you want to add authorized contacts, please use the blanks below.

By signing this authorization, the account owner is expressly requesting that the company share certain account information with authorized account contacts and is authorizing the company to share such in- formation with authorized contacts as necessary to address service, account inquiries and changes initiated by the account owner or any authorized contact.