HomeMy WebLinkAboutUSAMobility Sales and Service Agreement -2007 10 01
U~BJLlTY
ONE SOURCE FOR WIRELESS
o ~EW
o CHANGE
SALES AND SERVICE AGREEMENT Page_ of_ Total # of devices_
o "DO o~
D OISCONNE;CT
OFFICE coDe
CUSTOMER NAME
0>\,", Of' 1l1lm4
EQUIPMEN'T NO
EQUIPMENT PURCHAse
Ell' CREDIT (" APPLICABLE)
NO. OF INSTALLS/CHARGE
ANCILI.ARY EQUIPMENT CH.4RC;eS
SERVICE TYPEiMODEL
CHANNEUFREOUENCY
CAPCODI:
HOLDER
IS
IS
Inslsllmenr Term
(Total tax on Equipmenl billed up rron!.)
CU$lomer Liable for Bal6nce
Cuswmer IDals c:::::J
ACCOUNT DISCONNECT/SWAP FEE j
Account Di5conn&C!. F....' 525.00
Swap Fee, $10.00
DEVICE DR TELEPIfONE'AI
PIN
ADD/TIONA~ TIOlfPHONE.
D~lL COD.
SERVICE PkG ALI.OWISPER OVERCALL
O'ER DI$""lCH CAu. AUOWISPfR 0Y[JICAll
MSE RATE CHARGE
MESSAGe CAR90N COpy
DO FEATIJRE CODE/CHARGE
D FEATURE CODE/CHARGE
/$
is
/$
1$
1$
1$
1$
ICEMAIL CODE/CHARGE
SUB OF. MSE RECURRING CHRG$.
'RDlE:lBlAJIIJ COOElCHI\GIllEDIICnlllf
PTC CHARt;ES
EGULATORY/GOVT. PROGRAM FEES
~HEI\ RECURRING CMARGE~
T()TAL flr;CURRING CHARG~
COMMI2,,'-rs:
1$
is
1$
IS
VARIABLE
VARIABLE
T_ll!q~Ip",.m Che'll" i
Fln;\ Bill Plan'
Admin.. ConnectlCh=... 1
Admin. Fee $
Deposit S
To..' TlI. I $u~harg.. $
I undelsland the polieiO$ regard;
OAdm;n Fee
OAirtime Charges
[JAutornaliC paym
OCancellalio Ilcy & Fees
OEqUip. (gos & Returns
0011 all Plan OShipping Fee
aymenl Options Methods & OOli9~tlon.
und"rsr.nQ. that tho chafg"" auoclaled wl\h my b pllln
are stated in the contracllletllll section of this sale onlrac!.
Customer itj~15 [===:J
PAYMENT INFORMATJON
OW;A
AI'S
CR. C"'RI)"
AMI'
CARD HOLDER NAM~'
OMC
OOISCOVEr:l
DAM'l<
AMOUNT
IJc H
DCHECK
CHECK u
OAl"E
"'UTH. "
II
SIGNATURE'
AUTO'CHARG~ OPTION: CREDIT CARD CJ CHE
A""AC~
ACCT [=:J
P'f VOIDED' CHECK
MY SIGNATURE HEREUNDER ACKNOWLEDGES TI-<AT I HA
SALES SUMMARY CHECKLIST ABOVE AND I HAilE READ.
COiHRAC.TlJAL TERMS AND CONDITIONS APPEARING ON
THIS AGREEMENT AND IN THE SERVICE GUI
~MOeILlTYCOMlPDF'ISERVICEGUIDE PQf.. BY S
AUTHORiZe YOU to OHECK MY REFERENC~S ANO TO
ANOIOR COMPANY NAME TO CREDIT INr-ORMATION.BUREA
PURPOSES. I UNDERSTAND THAT THE APPI.ICABLE TAXES
WILL BE APPI.IEO AT THE TIME CJr INVOICING.
REVIEWED THE
NO ACC'PT THE
HE REVERSE OF
POSTED AT
NING IlI':LOW. I
BMrl MY NAME
FOR APPROVAL
o SURCHARGES
O.l\TE
>!TERNA, \JS. I)[;l v c=JNR INITIAL c=J Ole INITIALS
GRAND TOTAL DUE S.