Universal International Freephone Number Multiple ROAs Notification Form
(ITU-T Recommendation E.169)
To be returned to : UIFN Registrar
International Telecommunication Union
Telecommunication Standardization Bureau
Place des Nations
CH - 1211 GENEVA 20, Switzerland
Fax : +41 22 730 6200 Tel: +41 22 730 6220
Email : universalnumbers@itu.int
Part A to be filled out by the recognized Transmittal date: _______________
operating agency (ROA)
Company name /ROA _____________________________________________
Contact name _____________________________________________
Address _____________________________________________
_____________________________________________
Telephone number +____________________
Fax number +____________________
Email ____________________________________
UIFN number +800 __ __ __ __ __ __ __ __
IFS customer name 1) ____________________________
Customer’s address 2) ____________________________
____________________________
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1) The Registrar will not record any change of information if the customer’s name is not the same as the one
recorded in the Registrar’s database.
2) The Headquarters or Main Office address
(check appropriate box)
[ ] The above UIFN has been implemented
[ ] The above UIFN was disconnected
Date of activation is: ____ ____ ____
Day Month Year
Co-ordination (reference) Number : _________________________________
Reasons : ________________________________________________________
_________________________________________________________