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Union Cellular Service Contract TRI-STAR Regional Individual or Shared GAIT Plans (Cellular Phone Number) New Customer: Yes No Prior Customer: Yes No Publish Number: Yes No (Service Area) Purpose of Contract (Check at least one) see monthly service plan: New Service Activation: 1-year $35/phone or line Cust. initial 2-year $0 fee Cust. initial Rate Plan Change Cust. initial ESN Change Address Change Number Change Ownership Change Disconnect Cellular Phone Information: New Pre-owned Make: Model: ESN: ADDITIONAL SERVICES: MAIL STATEMENT TO: CREDIT FRAUD PROTECTION INFORMATION: Digital Handset Protection Program: Yes No Cust. initial Name: Request Voice Mail:* Yes No Cust. initial Deposit Required: Yes $ No Mailing Address: Bronze (FREE) Silver ($3.95/mo) Gold ($12.95/mo) Rec’d by: Additional Features: Physical Address: Customer’s Date of Birth: / / Multiple Access Numbers ($4.95/mo) City: Mother’s Maiden Name: Family Mail Box ($4.95/mo) Both Multiple Access Numbers & Family Mailbox ($8.95/mo) State: Zip: SS# or Tax ID#: Both Famiily Mailbox & Text Message Notification ($8.95/mo) Work #: Home #: Drivers License #: State: All Three (Multiple Access Numbers/Family Mailbox/Text Message Notification)($12.95/mo) * Voice Mail must be setup by subscriber within 30 days of activation to avoid voice mailbox suspension. Monthly Service Plan: As described in detail on the rate plan sheets. Roaming Charges may apply when you are in your calling area defined by your plan. TRI-STAR R E G I O N A L INDIVIDUAL OR SHARED G A I T PLANS Check No domestic long distance charges* to anywhere in the domestic U.S. from Union Cellular’s GAIT (TDMA/GSM) home calling area. No domestic long distance charges* for calls made within the states of WY, CO, UT, ID, MT, NV, AZ, NM, TX, WA, OR, CA, SD, ND or NE on Union Cellular’s Extended GAIT one, (TDMA/GSM) Network in these 15 States. Domestic long distance calls made outside of this defined region will be billed as low as $.20 per minute. (airtime charges apply**), except for calls made from Union Cellular’s home calling area noted above. No domestic roaming charges for calls made within the circle # 15 states noted above on Union Cellular’s GAIT (TDMA/GSM) Extended Network. Roaming calls outside of this defined region will be billed as low as $.69 per minute. (Includes domestic long distance charges***) * Airtime charges apply. Promotional* of lines ** Long distance charges may also apply to calls received. ** * Domestic long distance is an additional $.20 per minute for calls Mobile to Mobile Minutes: Yes No & write received while roaming. in total Additional Monthly Access Charge: Individual Shared charge: 1 Phone - No Charge Monthly Monthly Rates Individual or Rate Per 2 to 5 Phones - $10.00 per month PLANS Rate Number of Service Lines * For use only when Promotional Mobile to Mobile Minutes are being offered. Shared Anytime Additional Minutes 1 2 3 4 5 TOTAL CHARGE (Monthly Rate + Mobile to Mobile) Free Minutes Tri-Star Regional GAIT 450 $0.45 $34.95 $54.95 $74.95 $94.95 $114.95 450 Minutes Tri-Star Regional GAIT 650 $44.95 $64.95 $84.95 $104.95 $124.95 650 Minutes $0.40 Tri-Star Regional GAIT 850 $54.95 $74.95 $94.95 $114.95 $134.95 850 Minutes $0.40 Tri-Star Regional GAIT 1200 $64.95 $84.95 $104.95 $124.95 $144.95 1200 Minutes $0.35 Tri-Star Regional GAIT 1550 $84.95 $104.95 $124.95 $144.95 $164.95 1550 Minutes $0.35 Tri-Star Regional GAIT 1950 $104.95 $124.95 $144.95 $164.95 $184.95 1950 Minutes $0.30 Tri-Star Regional GAIT 2550 $134.95 $154.95 $174.95 $194.95 $214.95 2550 Minutes $0.30 SPECIAL REQUESTS: NOTICE TO CUSTOMERS: This document, when signed, represents a contract between Customer and Signed this day of , 200 Union Telephone Company. The terms and conditions of this agreement (SEE REVERSE) are understood and acceptable. I authorize an investigation of my credit and employment history and the release of information about my credit experience. Contract is not valid without signature. Print Name: Signature: Union Telephone Company - PO Box 160 - Mountain View, WY 82939 - 1 (888) 926-CARE (2273) Terms and Conditions Accompanying Union Cellular’s Contract for TRI-STAR Regional Individual or Shared GAIT Cellular Service Plans. 1. UNION TELEPHONE COMPANY INC: with corporate offices located in Mountain View, Wyoming, is the provider of the cellular service herein known as Union Cellular. 2. MINIMUM SERVICE: This agreement entered into between Customer and Union Cellular is for a minimum period as indicated on the CELLULAR SERVICE CONTRACT - TRI-STAR REGIONAL INDIVIDUAL OR SHARED GAIT PLANS. 3. COMPANY BILLING POLICIES: Bills are due and payable upon receipt. Union Cellular mails a reminder to all customers whose bill is still outstanding after the due date. Any customers with an outstanding bill more than 15 days overdue will be disconnected for non-payment. Restoration of service requires payment of outstanding debts plus a $20.00 fee. 4. CUSTOMER AND UNION CELLULAR MUTUALLY PROMISE, COVENANT AND AGREE: a. That the word “customer” as used herein shall be construed as including the original applicant executing this agreement and all subsequent persons who may now or hereafter receive cellular service, and it is expressly understood and agreed that Union Cellular’s obligation to furnish cellular service to the customer is conditioned upon timely payment by the customer for all billings rendered by Union Cellular. b. That this application and interpretation of this agreement shall be in accordance with the terms and conditions of Union Cellular’s cellular telephone tariffs now on file, and as they may from time to time be amended; such terms and conditions constituting a part of this agreement and binding on the parties hereto. c. That airtime is charged in one-minute increments while the phone is in operation, whether the customer initiates the call or whether the customer receives the call. Calls are timed from the time you press SEND to a few seconds after you press END while the network confirms completion of your call. d. That from time to time the customer may “ROAM” on the services of another cellular company, and that the charges incurred for these services will be included in customer’s monthly billing as they are received by Union Cellular. The billing for these roaming services are the result of the policies of the company providing the services and are therefore not subject to Union Cellular’s control. e. That cellular telephone service is mobile telephone service and the device providing said service may or may not be secure from unauthorized use. Customer shall insure that the cellular telephone is either secured or locked when not in use; and further, customer will notify Union Cellular if the cellular telephone is lost or stolen. Customer understands that in the event that the cellular phone is stolen or in the hands of an unauthorized user, the customer is responsible for all service provided until such time as customer reports such information to Union Cellular and Union Cellular has deactivated the customer’s telephone number. In keeping with the cellular industry standard, Union Cellular requires a police report verifying a stolen phone in order to deactivate the cellular telephone on a nationwide basis. 5. CUSTOMER AGREES: a. That should the customer terminate their contract with Union Cellular prior to the end of the contract, the customer will be required to pay an early termination fee of $25.00 per phone per month for each month remaining on the contract. b. To pay any deposits which may be required by Union Cellular to secure a customer’s account. Such deposits may be returned only after all billings rendered have been paid in full for the signed contract period. Should there be an unpaid balance on a bill or if a customer is disconnected for non-payment within the signed contract time period Union Cellular will hold customer’s deposit for the term of the contract. c. That should the customer move from Union Cellular’s service area, or Union Cellular deactivates customer permanently for non-payment, any applied deposit will be returned against the account only. Any credit left from the deposit will be refunded after all bills incurred have been processed. This includes, but is not limited to such items as toll charges, local and roaming airtime charges, early termination fees and service order charges. d. Not to use cellular telephone service and/or facilities for unlawful purposes, including but is in no way limited to the use of profane language or impersonation of another individual with fraudulent or malicious intent. e. In the case of non-payment, customer shall be liable for all costs, expenses and attorneys fees; in case of suit the makers and endorsers hereby waive presentment, demand, protest and notice thereof. f. That should the customer choose a Shared Plan all users will be billed on one bill and to the same address. The individual signing the contract will be responsible for payment of all charges. All users on the selected Shared Plan will share the pooled free minutes. No more than five (5) service lines may be activated on a Tri-Star Regional Shared GAIT Plan. The activation fee for a Shared Plan is $35.00/phone for a 1-year contract, $0.00/phone for a 2-year contract. The monthly rate charged only to the first phone. The monthly rate charged is dependent on the number of service lines activated. 6. UNION CELLULAR PROMISES, COVENANTS AND AGREES: To notify customer when cellular service is activated, and to supply that service when requested, subject to the rate schedule in the tariffs now or hereafter in effect.
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