Disclosure of Customer Information to Unify Networks

Disclosure of Customer Information to Unify Networks
I, First Name*   Last Name*      am an authorised representative of Company Name*   and have authority to consent on their behalf to the disclosure of the information specified below to Unify Networks.

Please accept this letter as confirmation that gives Unify Networks consent to the disclosure of the information specified below to Unify Networks for a period of 6 months from the date of signature below.

The purpose of the disclosure is to enable Unify Networks to:-
-       market BT’s electronic communications services to Company Name*
-       provide BT’s value added services to Company Name*

Please provide a current BT telephone number:   Country Code*   Area Code*   Phone Number*
Please select Yes or No for each option
Private Circuit details -Product Services ID (circuit number); Description (circuit type); Address Information (A & B end)*
Other telephone service installation details (including address information, telephone numbers, product / service, BT Retail Broadband services, rental charges.)*
Contract end date(s) for line(s) *
Name*

First NameLast Name
Position*
For and on behalf of (company name)*
Date*

MonthDayYear
Date
Signature*

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The meaning of the word partner or partnership in this communication is governed solely by the terms of the commercial agreement(s) and / or arrangements in place between BT and its partners. It does not give rise to a partnership as defined in the Partnership Act 1890 and any such meaning is expressly rejected by BT and its partners.

Important: Withdrawal of consent only
You can withdraw the consent you have given for BT to disclose information to the partner named above by contacting BT Business Partner Sales on 0800 679606
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