Text Box: Residential and Business 
Long Distance 
Application for Service

 


Customer Authorization

The undersigned authorizes Trans Texas Technologies Long Distance (3TLD) to provide Long Distance service. (Please check only one plan)

 

 

PLAN 1 8 per minute - $4.95 Monthly Fee

 

Check box for travel calling card

 

 

 

 

 

PLAN 2 10 per minute - $2.95 Monthly Fee

 

 

 

 

 

PLAN 3 15 per minute No Monthly Fee

 

General Terms and Conditions

All Trans Texas Technologies Long Distance (3TLD) charges and other terms and conditions are governed by the applicable Trans Texas Technologies Long Distance (3TLD) tariffs or consumer service agreements and service guides, as applicable, as they may be amended from time to time. Visit www.transtexastechnologies.com to view Trans Texas Technologies Long Distance (3TLD) tariffs or consumer service agreements and service guides. Your telephone company will charge a PIC change fee of $5.00 per jurisdiction/per line for changing your long distance carrier. 3TLD will reimburse you the PIC change fee of $5.00 per jurisdiction/per line on your first billing.

 

Customer and Billing Information

My signature on this form authorizes Trans Texas Technologies Long Distance (3TLD) to provide long distance service for:

 

 

Both Inter/IntraLATA

 

 

InterLATA

 

IntraLATA

*Only one monthly fee will be charged

 

Customer Signature ______________________________________ Print Name _____________________

 

Address _______________________________________________________________________________

 

Billing Address (if different from above) _______________________________________________________

 

Customer Phone _______________________ Customer Tax ID____________________ Date___________

 

3TLD Internal Use Only

 

3TLD Acct # _____________________________ In-Service Date _______________ SO # _____________

 

3TLD Representative ___________________________________ E-Mail_____________________________

 

Fax Number _______________________________ Phone Number________________________________

 

CPNI Information:

 

Yes, consent given

 

No, consent denied

 

Trans Texas Technologies Long Distance (3TLD) Confidential Information.