Iridium Service Activation Request Form by olliegoblue33

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									IRIDIUM® FLIGHT TRACKING ACTIVATION REQUEST
Please return to Stratos: Attn. Sales Department
                          Sales Contact, if known:                                                                                                 ®

THIS FORM SHOULD NOT BE USED FOR ANY OTHER IRIDIUM SERVICE ACTIVATION

 Check one box:
    Bethesda, Maryland                    Ottawa, Ontario                      St.Johns’, Newfoundland                   Weston, Florida
 Phone: +1 301 214 8800                Phone: +1 613 230 4544              Phone: +1 709 748 4233                    Phone: +1 954 217 2256
 Fax: +1 301 214 8801                  Fax: +1 613 230 4212                Toll Free: 1 888 766 1313                 Toll Free: 1 800 848 9660
                                                                            Fax:     +1 709 748 4300                 Fax:      +1 954 217 2272

    Seattle, Washington                   London, England                     Asia-Pacific
 Phone: +1 206 633 5888                Phone: +44 20 7 562 4826            Phone: +852 2918 8250
 Toll Free: 1 800 250 8962             Fax:   +44 20 7 562 4884            Fax:    +852 2918 9808
 Fax:      +1 206 633 5871


This form is used to register and/or activate Iridium satellite equipment and SIM card ("Equipment") for flight tracking services ("Services") with
Stratos. Customers are required to complete ONLY the section and/or information pertaining to their chosen Equipment and Services option,
then return the completed form to Stratos via facsimile at the applicable fax number. Upon activation of the Equipment and Services, Stratos
will assign Customers with numbers for the selected additional services and include such numbers in Section C of this form. Stratos will then
return this form back to the customer for their records.
All new Customers must submit a completed Subscriber Application and Services Agreement, along with this completed form prior
to the registration and/or activation of the Services. The Subscriber Application and Services Agreement are available from your
authorized Stratos Dealer, your Stratos Account Manager, or on Stratos’ website at www.stratosglobal.com. Service activation requests from
new customers that do not have a Subscriber Application and Services Agreement attached will be returned to the Customer. Activation of
Equipment and Services is contingent upon Stratos’ review and approval of Customer’s Subscriber Application and Services Agreement and
Stratos reserves the right to request additional credit information from Customer.


                                       PLEASE PRINT CLEARLY & COMPLETE ALL SECTIONS THAT APPLY
 SECTION A: CUSTOMER INFORMATION (Must be completed by Customer)

 Name:                                                                      Date:
 Company Name (if applicable):
 Address:




 Telephone:                                                                 Fax:
 Name of Retailer:
 IRIDIUM WORLD SATELLITE SERVICE INFORMATION (To be completed by Customer, if applicable)
 IMEI (15-digit serial # located on handset’s package)                     SIM Serial Number (19-digit serial number on reverse of SIM Card)




 IRIDIUM FLIGHT TRACKING INFORMATION (To be completed by Customer If, applicable)
 S200 or LMC Serial Number:                                                (For commercial web access only)
                                                                           User Name:


 Aircraft Asset (Tail) Number:                                             Password:

 Commercial Service W/ web access:                                         SBD Destination addresses:
                                                                           idata@latitudetech.com
 Yes   □         No    □                                                   idata2@latitudetech.com
 AFF.GOV tracking:
                                                                           ltcdata@telus.net
 Yes    □         No   □                                                   ltcdata2@telus.net


                                                         Page 1 of 2                                                             Revised 1/26/06
   IRIDIUM® FLIGHT TRACKING ACTIVATION REQUEST
   Please return to Stratos: Attn. Sales Department
                             Sales Contact, if known:                                                                                                ®

   THIS FORM SHOULD NOT BE USED FOR ANY OTHER IRIDIUM SERVICE ACTIVATION

     SECTION B: SELECTED IRIDIUM SERVICE RATE PLAN (Must be completed by Customer)
                                                                   Additional Services:
     Voice only
                                                                   Flight Tracking (Recurring One (1) year contract, cancellation fee is $250)
     Voice and SBD                                                 Voice Mail Service
     SBD only                                                      Data Service
                                                                   Two-Stage Dialing
                                                                   Short Burst Data

     SECTION C: ASSIGNED IRIDIUM SERVICE NUMBERS (To be completed by Stratos)
     Iridium Satellite Service Phone #:




     MSISDN-C Data Service Number__________________________________________________________________________________

     SECTION D: CUSTOMER SERVICE ACCEPTANCE (Must be completed by Customer)
     By signing below, I hereby certify that I am an authorized representative of the company ("Customer") and I agree that a facsimile copy of this
     form will be valid and binding for all purposes. I understand that the Services and/or Equipment requested herein will be provided by Stratos,
     except as otherwise specified by Stratos, pursuant to the applicable terms and conditions posted on Stratos' website at
     www.stratosglobal.com ("Terms") and at the prices provided to Customer by Stratos ("Prices"). Customer agrees to be bound by the Terms
     and Prices (each as amended by Stratos from time to time) applicable at the time of the provision of Services, unless Customer enters into a
     separate written agreement with Stratos for the Services. Accordingly, Customer's use of the Services will be subject to the terms and
     conditions, including price(s), of such agreement, when executed by both parties. Customer has been provided ample opportunity to review
     the Terms. Customer takes particular notice that the Terms include specific clauses, including but not limited to: (A) LIMITATION OF
     LIABILITY; (B) LIMITATION OF IMPLIED OR STATUTORY WARRANTIES; AND (C) INDEMNITY, HOLD HARMLESS, AND DEFENSE OF
     THE PARTIES, and herein certifies that such clauses have been brought to Customer's attention.

     CUSTOMER SIGNATURE:                                                                         DATE:


     SECTION E: CUSTOMER VERTICAL MARKET (Must be completed by customer)

     MI    Marine – Industrial                     GS   Gas                                           CN    Construction
     MR    Marine - Recreational                   AV   Aviation                                      FY    Forestry
     GT    Government                              RF   Disaster Relief / Emergency Services          RT    Rental
     RC    Recreation                              MG   Mining
     OL    Oil                                     BT   Business Traveler




   The pin code will default to 1111. Account will be activated and Iridium phone/pager numbers sent to the customer within 24 hours of credit
   approval Voice Customers Only. We encourage you to dial 6868 direct from the Iridium handset. Although this is not required to activate
   your service, you will reach a satellite operator who can confirm your connectivity and provide you with any needed assistance. This is a toll-
   free call from your Iridium handset.

   For any customer support issues regarding your Iridium Satellite Equipment and/or your Stratos airtime service, please contact Stratos
   Customer Care at:            1 877 578 7286 (within North America)
                                +1 709 748 4212 (outside North America)
                                6868 (From your Iridium handset)
                                support@stratosglobal.com



CSR ID:                              Request ID:                         Voice Contract #:                       Paging Contract #
Sales Order #:                       Cust Acct:                          Time:                                   Date:




                                                           Page 2 of 2                                                            Revised 1/26/06

								
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