Signup Form

VoIP Sign Up

To sign up for our VoIP Services, please complete all questions.
Name

First NameLast Name
E-mail
example@example.com
Phone Number

Questionnaire
How many phone users do you have?
How many IP phones do you currently have?
Do you want your users to call using the app, soft phone (computer), physical phone, or all of the above?

AppSoft Phone (computer)Physical PhoneAll of the above

Letter of Agency (LOA) & Customer Service Records (CSR) Request:

Please fill this out if you have any numbers to bring over.
My signature below certifies that I am the customer of record or the authorized representative for payment for each of the telephone numbers listed below.

For each of the telephone numbers listed herein and on Attachment A, I appoint HNL Corp (hereinafter HNL Corp) to act as my Agent for the purpose of collecting my account information with my current local telephone carrier or provider (hereinafter “Provider”).

By selecting HNL Corp to act as my Agent to research my current services with my current Provider of local telephone service, I am authorizing the change of my local telephone Provider from that/those which I am currently using to HNL Corp. This authorization will expire only with written notification.
Billing Telephone Number (BTN)
Please enter a valid phone number.
Losing Carrier:
Losing Carrier Account Number:
LOA Instructions:

1. Only one (1) BTN may be associated with each LOA. If you have additional BTN's, you must submit a LOA for each BTN. Please contact your HNL Corp representative if you need assistance identifying each BTN.

2. Please provide a copy of the most recent losing carrier invoice for the BTN listed above (must include ALL pages). The information on this LOA MUST match the attached losing carrier invoice.

3. Use Attachment A for listing all telephone numbers associated with this BTN.
Please Type:

This information MUST match your current invoice and account information.
Customer (Company) Name
Account Contact:
Title:
Phone Number (your phone #, NOT BTN):
Please enter a valid phone number.
Service Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature

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Date

MonthDayYear
Date

Attachment A:
Billing Telephone Number (BTN):
Please enter a valid phone number.
Only one (1) BTN may be associated with each LOA. If you have additional BTN's, you must submit a LOA for each BTN. Please contact your HNL Corp representative if you need assistance with identifying the proper BTN.
Telephone Numbers TO BE PORTED:
The numbers listed in this table WILL be ported. Please clearly indicate if any numbers are associated with DSL line, Fax, or if a part of a Centrex type service. For example: 111‐111‐1111, dsl line 222‐222‐2222, main number 333‐333‐3333, fax line
Telephone Number that WILL NOT be Ported
The numbers listed in this block WILL NOT be ported to HNL Corp. They will remain with the losing carrier. Please make certain all numbers are accounted for so that your number porting is not rejected for inaccuracies. NOTE: If the BTN is being ported to HNL Corp, you must identify a new BTN for the numbers that WILL NOT be ported.

Responsible Organization Letter of Authorization

Please fill this out if you have any TOLL FREE Numbers you need to bring over. 800 Resporg Authorization Resporg ID: BSU01
Company Name
Contact Name
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Billing Account Number:
Company Phone:
Please enter a valid phone number.
Delivery Date

MonthDayYear
Date
Choose ONE:

Change RESPORG to: HNL CorpNew 8YY
Applicable Toll-Free Numbers and Information:
New Resp Org ID: LQX01
Enter Numbers Below (one per line):
Customer Authorization: Appointment of Agency

The undersigned customer ("Customer") hereby appoints HNL Corp ("HNL Corp") to act as its authorized agent for all matters pertaining to the 8YY services listed above. This agency includes the ordering of rearrangement of services, assignment to primary carrier services requests, disconnection of service and other requests as deemed necessary by CoreDial to implement the 8YY services ordered from CoreDial and itemized on Customer's Service Order Form(s) and associated attachments. This authorization will expire upon written notification only.
Accepted by Customer:
Customer Name

First NameLast Name
Signature

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Date

MonthDayYear
Date
Should be Empty:

VoIP Sign Up

Questionnaire

Letter of Agency (LOA) & Customer Service Records (CSR) Request:

Please Type:

Attachment A:

Responsible Organization Letter of Authorization

Customer Authorization: Appointment of Agency

Accepted by Customer: