RESPONSIBLE ORGANIZATION DESIGNATION AND AGREEMENT OF AGENCY
TOLL FREE NUMBERS TO BE PORTED TO ID ‘UXC01’
I hereby designate MTS Allstream Corp. ("Allstream") to act as Responsible Organization ("RESPORG") for the following Toll Free service
telephone numbers (the "Toll Free service numbers"). I further designate “Allstream” to act as my agent to transfer RESPORG functions to
“Allstream”. These designations supersede all prior RESPORG designations pertaining to these Toll Free service numbers.
Section One : Customer Information
Company Name:
Address:
Contact :
Phone Number:
Fax Number:
Authorized By:
(Customer Signature)
(Print Name)
(Title)
(Date)
Section Two: Toll Free Numbers To Be Ported To ID ‘UXC01’
List Toll Free Service Numbers for which RESPORG functions are being transferred in chart below. If more than 9 numbers are required,
check the box below and attached a separate list as an Excel file.
SEE ATTACHED LIST
MTS Allstream OTS Ref #
CURRENT RESPONSIBLE ORGANIZATION
(TF Dept Use Only)
NEW RESPONSIBLE ORGANIZATION
Carrier Name:
Carrier ID:
Section Three: Allstream Sales Information
Sales Rep:
Phone:
CBM/CSR/OE:
Phone:
(Ver.august15-2011)