Hostgsm

Delegation of Authority

Date

Current Provider Customer Information

Name

Contact

Title

Phone

Authorized Signer

Billing Contact

Current Billing and Service Location Information

Name

Address

Address2

City, State Zip

County

Billing Address

Service Address

Phone Number Porting Details

Desired Port Due Date (Must be no less than 7 business days. Your transfer is NOT guaranteed to be on this date)

ASAP

Current Service Provider

Account Number

Please list all numbers to be transferred below

Current Account or Billing Telephone Number (ATN or BTN)

Partial Port :-

YesNo

If Partial Port Please Specify New ATN/BTN :-

Notes:

Ensure all the current information on file with the current provider aligns.
Only share new service information with your current provider or cancel after knowing this, or you may lose your number.
In case of a change in the transfer date, we shall communicate this to you as soon as possible through email or the service ticket.
After the porting of the said number to [HOSTGSM. COM LLC]’s Telco Network, the line will ring your Voice Service.
Finally, it is beneficial to contact your previous utility service provider and inform them that you no longer require their services.
Make sure all these forms are precise and all parts have been filled appropriately.

By signing below, I acknowledge that I am, or for a business, the above named local service customer and [for a business ] am, or represent a company; the signatory’s signature is that they or she has the authority to change the primary carrier(s) for the listed telephone number(s) and that the signatory is at least 18 years of age. The name & address given here are as appears on my local telephone company records for each listed number for business solutions in the cloud. I have granted [hostgsm.com llc] or its agent permission to contact my current carrier(s) of choice, request them to change preference and provide me with relevant information about my lines, carrier/customer data, billing address and other credit information in business voicemail system.

Customer Authorized Signature:

Printed Name:

Title:

Date: