Copy onto your letterhead, sign and date.  Fax to 601.853.9719, or email to mphillips@southernvoice.net.  For more information, contact Michelle Phillips at 601.853.7616 ext. 100.  This form valid only in Mississippi, Alabama, Louisiana, and Tennessee.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Attention:  Manager

 

We have on this date entered into a contractual agreement with Teleco Mississippi  to act as our communications representative.

 

Under the terms of this letter, we do hereby authorize Teleco Mississippi  to handle the negotiations for the connection of service on our telephone system.  The service will be located at ________________________________________________________________.

Our telephone number is ______________________.

 

On this date, we hereby specifically authorize the release of any billing information and/or equipment records to Teleco Mississippi  for the telephone system at P.O. Box 215, Madison, MS  39130, 601-853-7616.

 

This authorization does not prevent our company from acting on its own behalf when it is necessary.

 

Your contact at Teleco Mississippi will be Michelle Phillips, who can be reached at 601-853-7616-ext. 100..

 

 

Customer’s Signature

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