Number Transfer Authority

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					                                                                                                    Alltel Pty Ltd
                                                                                                   29 135 562 522)
                                                                                              (ABN 66 178 860 153)
                                                                   Level 1, 13b Civic Place Ringwood Vic 3134
                                                                        Phone: 1300 ALLTEL (1300 255 835)
                                                                                            Fax: 1300 799 948
                                                                                 Email: support@alltel.com.au


              Number Transfer Authority
  Please TYPE YOUR DETAILS in the highlighted fields.
                          Then print it, sign it and fax it to 1300 799 948.
Thank you for choosing Alltel Pty Ltd (Alltel). All information provided in this Number Transfer Authority will
be held in strict confidence and will only be used by Alltel to provide Alltel’s business communications and
associated services.
Section 1 – Customer’s          Business Account Details
* Customer’s Company Name
/ Legal Entity
                 To transfer your numbers to Alltel, FIRSTLY you need to open an account using the
                             (New) Account Application Form (available on our websites)
* Existing Alltel Account Number
(if you are a new customer, please specify "NEW")

Section 2 – AGREEMENT            & AUTHORITY TO CHANGE PROVIDER OF TELEPHONE SERVICES
(FORM ET CAF 001)

I certify that I have the authority to authorise this change and these details are correct. I understand that by
nominating Alltel Pty Ltd (Alltel) as the preferred carrier for the telephone number(s) below, Alltel will become
the carrier of choice for the Line Rental, Local, National and International Long Distance Services, and any
other pre-selectable services charged to this number.
I authorise Alltel to take any further action, including signing any documents on my behalf, to give effect to
this change.

Signature: X _______________________________________                Date: ____________________________

Authorised persons name: ________________________________________________________________

Position in Company/Business:
Section 3 – Existing Provider Account Details
Your current account may be with a reseller of a larger, wholesale carrier. To transfer a number successfully,
we need the reseller's account number with their wholesale carrier, often know as their "wholesale porting
account number". If your numbers are already carried directly by a large carrier (eg. Telstra, Optus, Primus,
AAPT etc) then your normal account number will usually suffice for transfer purposes.
Your existing Account is with:

Your account number with this company:

Reseller's wholesale Carrier (eg. AAPT etc):
Reseller's Carrier WHOLESALE PORTING ACCOUNT NUMBER:
Section 3 - DETAILS OF NUMBERS BEING TRANSFERRED - Fixed Landline numbers &/or 1300/1800 numbers

Please write telephone number(s) below indicating your choice of Alltel as your preferred provider of pre-
selectable and local telephone services. Please include all your Fixed landline, Fax, Modem and 1300/1800
numbers.
                                      Alltel Pty Ltd (ABN 34 111 581 830)
                                                          66 178 860 153

    Area Code              Telephone Number                Area Code               Telephone Number




If you have more numbers than above space allows, please copy this page and include in your application.

Section 4 – Customer Declaration

I/We …………………………………………………………………………………………………………………..
hereby request Alltel to provide me/us with the Services and agree that I/we;

•     Have read, understand and accept Alltel terms and conditions and Privacy Statement displayed at the
      applicable Alltel website or Alltel dealer’s website or at www.alltel.com.au/privacy.html
•     Unless otherwise stated are not under any term contract and may cancel the Services at any time by
      providing Alltel with one month’s prior written notice.
•     Understand that rates charged by Alltel for the Services are published at the applicable website owned
      by Alltel and/or are available on request and that these may change from time to time;
•     Declare that information provided in this Number Transfer Authority is true and correct and will be relied
      on by Alltel to provide the Services;
•     Understand that Alltel may perform a credit check upon application.
•     Are legally authorised to sign this Account Application Form.


Signature: X _______________________________________                 Date: ___________________________

Signature: X _______________________________________                 Date: ___________________________


WHAT NEXT?



Please FAX ALL OF THE ABOVE

the first 3 summary pages of your most recent, current
phone account for the number/s you are transferring.
                                    to Fax 1300 799 948

				
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Description: Number Transfer Authority