|
Phone Number (712) -______________________
| Name: |
____________________________________ |
| Service Address |
____________________________________ |
| Billing Address:: |
____________________________________ |
| City: |
____________________________________ |
| State: |
Iowa |
| Zip: |
____________________________________ |
| Social Security #: |
____________________________________ |
| Employer: |
____________________________________ |
Previous Telephone #:
|
____________________________________ |
Calling Features
|
| __________ Call Waiting |
Free |
| __________ Caller ID |
Free |
| __________ 900 Blocking |
Free |
| __________ Call Forwarding |
Free |
| __________ 3-way Calling |
Free |
Wire Maintenance
Plan
|
| __________ Monthly Cost: $.50 The Wire Maintenance
Plan protects you from expenses relating to the inside telephone
wiring in your home. If you subscribe to this service, STC
will repair or replace any inside wiring that creates a service
problem. |
900 Number Blocking
|
| __________ Yes, I would like STC to block access to all 900
telephone numbers dialed from this phone line. ( There is no
charge for this service.) |
PIC Freeze
|
| __________ Yes, I would like STC to enact a "PIC Freeze" on
any changes to my long distance carrier. I understand that
with the PIC Freeze in place, all requests for long distance
carrier changes will be rejected unless notification is
received by STC from the customer prior to receipt of such
a request. (There is not charge for this service.) |
Total Local Services
|
| Schaller Local Telephone Service |
$__________ |
*Residential $11.50
|
*single line access $6.50 + tax
|
*Business $15.00
|
*single line access $6.50 + tax
|
*multi line access $9.20 + tax
|
| Wire Maintenance Plan |
$__________ |
| Subscriber Line Charge |
$__________ |
| E911 Surcharge |
$__________ |
Buena Vista County $1.00
|
Crawford County $1.00
|
Ida County $1.00
|
Sac County $1.00
|
Woodbury County $1.00
|
| TOTAL Local Service Charges |
$__________ |
| *Does not include federal, state and local taxes,
or long distance charges that will be added to your monthly
bill. |
Long Distance
|
| I choose the following company(ies) as my long
distance carrier(s): |
Name of Inter LATA Carrier: _____________________
|
CIC Code _____________ |
| |
|
Name of Intra LATA Carrier: _____________________
|
CIC Code _____________ |
| |
|
| 4 Digit code assigned by Carrier |
|
| Toll Restricted |
9999 |
|
| ANC |
0342 |
Call 275-4211 to set up account |
| AT & T |
0288 |
Call 800-222-0300 for residential; 800-222-0400 for
business |
| MCI |
0222 |
Call 800-444-2222 for residential; 800-444-3333 for
business |
| SPRINT |
0333 |
Call 800-877-4500 for residential; 800-877-4020 for
business |
|
Agreement
|
| In making this Application, the undersigned agrees
to the rules and regulations of Schaller Telephone Company
as set
forth in this tariff and Communications Policy, and to the
general changes in rules or rates for the service furnished
under this
Application. |
| Applicant's Signature: |
_________________________________ |
| Application Taken By: |
_________________________________ (emp initials) |
| Date: |
___________/__________/___________ |
Serving Cushing, Galva, Kiron, Schaller
|
