Toll-Free Number Transfer Request (RespOrg)

Toll-Free Number Transfer Request (RespOrg)

Enter your customer and account details, list the toll-free numbers to transfer, and e-sign to submit the request.
Toll-Free Number Transfer Request
The undersigned Toll Free number holder does hereby appoint cTel L.L.C. as the Responsible Organization for toll free numbers.
Customer Information
Company Name
Company Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Contact Name
Contact Title
Email
example@example.com
Authorized Customer Tel #
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Customer Fax #
Please enter a valid phone number.Format: (000) 000-0000.
Account Information
Current Phone Carrier
Acct Number
Acct Pin
Provided PIN # (internal use)
Toll-Free Numbers
List each toll-free number being transferred along with the local number it currently forwards to. Different toll-free numbers may forward to different local numbers — fill in as many pairs as apply.
Toll-Free Number #1
Forwards To (Local Number) #1
Second Toll-Free Number
Forwards To (Local Number) #2
Third Toll-Free Number
Forwards To (Local Number) #3
Fourth Toll-Free Number
Forwards To (Local Number) #4
Fifth Toll-Free Number
Forwards To (Local Number) #5
Sixth Toll-Free Number
Forwards To (Local Number) #6
Seventh Toll-Free Number
Forwards To (Local Number) #7
Eighth Toll-Free Number
Forwards To (Local Number) #8
Ninth Toll-Free Number
Forwards To (Local Number) #9
Tenth Toll-Free Number
Forwards To (Local Number) #10
NEW RESPORG: WLS27
New RespOrg Contact: EASTERN REP
New RespOrg Telephone #: (541) 593-2900
New RespOrg Fax #: (541) 593-2090
By selecting the "Submit" button, you are signing this Request electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Request. By selecting "Submit" you consent to be legally bound by this Request's terms and conditions. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, or to otherwise provide cTel, or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and cTel. You also represent that you are authorized to submit this Request for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Request.
Certification & Signature
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Toll-Free Number Transfer Request (RespOrg)

Toll-Free Number Transfer Request

Customer Information

Account Information

Toll-Free Numbers

Certification & Signature