Sales Dealer Rep Agreement by ceu31829


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									                                                                                         Representative Information

                                                                           Sales ID: ___________ Sales Rep: __________________

                                                                           Contact #:

                                          Clear Service Order Form
Name:                                                        Home Phone:                   ____ 2nd Phone _________________

Address:                                                     Porting Phone? ______         Porting Company: ________________

City:                     State: _____ Zip:                  Current E-mail address:

DOB: ___________________ SSN: __________________             Desired user name:

                                                             RSU/USB Mac Address:          _______________________________
Expiration Date:                  3/4 security #: _______
                                                             USB Mac Address:              _______________________________
Billing Address: ___________________________________
                                                             USB/ATA Mac Address:          _______________________________
City:                     State: _____ Zip:

                    Clear Services and Rates                                Equipment

             Take Three Clear Internet $80
                                                                            RSU Modem Lease          $5 /Month     ____
            ___ Home + Mobile + Voice $80/ Month
                                                                            RSU Modem Purchase       $85           ____
            ____ Upgrade to Clear Internet + ($10)/ Month*
                                                                            USB Modem Purchase       $80           ____

                                                                            USB Lease                 $4           ____
               Take Two Clear Internet $60
                                                                            4G Personal Hotspot       $5           ____

            ____ Home + Voice $60/ Month                                     VoIP Adapter Purchase   $15.00
            _____ Home + On the Go $60/ Month
                                                                            4G+ Sierra/Hotspot        $9           ____
            _____ Get 2 on the Go $60/ Month
                                                                            4G+ Hotspot Purchase      $225         ____
            _____ Upgrade to Clear Internet + ($10)/ Month
                                                                            4G+ Purchase Sierra       $115         ____
                   Get One Clear Internet $45
                                                                             I-Spot/Purchase          $100            ____
            ____ Home

            ____ On the Go
                                                                            I-Spot service Monthly    $25             ___
            ____ Upgrade to Clear Internet + ($10)/ Month*

                                                                                       Service Agreement Term

                     Home Internet 1.5MB                                    2 Yr. Agreement - Activation Fee Waived
           ____ Basic Home $35/ Month
                                                                            Month to Month $35.00 Activation Fee
           ____ Basic Home + Voice $50/ Month

        *$10 upgrade per device added for 4G+ device.
                                CLEAR CUSTOMER SALES REVIEW
SET UP: My rep reviewed the set up instructions and requirements for my service with me
___ I will need an Ethernet port or Ethernet adapter on my pc to connect the RSU modem.
___ I will need to install the USB drivers to be able to use my USB device.
___ I will need to purchase a wireless router for my RSU modem if I wish to connect wirelessly. I will
have to set up my router on my own or with the help of a computer technician.

 CUSTOMER SUPPORT: My rep informed me of the customer support options available
___ I can reach tech support at 1-888-888-3113, this is a free service.
___ I can get online info and support at
___ I can access online account management on My Account at

BILLING: My rep reviewed the billing process
___ I am automatically billed each month on my debit or credit card
___ The date I sign up is my regular billing day. If I sign up on the 5 th, the 5th of each month my bill
will cycle.
___ I am billed in advance for service each month
___ Charges include the service plan and lease fee if I did not buy my equipment and any applicable
taxes for lease or phone service fees.
___ There may be a preauthorization placed on my card at the time of sign up but it will drop off after
the sale is processed. This is not an additional charge.

FEATURE SET: My rep reviewed the available service features
___ How I set up my email account.
___Where I can update my account info:
___ Where I can access my account instructions to set up or change my phone options such as voice
___ If I am porting my existing home phone number my port has been initiated.
___ Explained to me that if I’m porting my number I must keep my old service active until the port is
complete so I do not lose access to that phone number. I understand that I will have to pay for both
services until that is complete and it may in some cases take up to 30 days. Normally it will only take
about 1-2 weeks.
___ Made test calls to and from my phone to insure it was set up properly.
___ Explained to me that I cannot accept collect calls with this service and I will be charged for use of
directory assistance and international calling.

TERMS: My rep informed me that
___ I have signed up for a 2 year agreement
 ___ I have signed up on a month to month agreement with purchase of the equipment and a $35
activation fee.
___ Terms of service are available at and include a cancellation policy and
early termination fee explanation. I will have an early term fee or restocking fee if I cancel before my
2 year agreement is fulfilled.
___If I lease my equipment I understand it must be returned to Clear. I have to call customer care to
cancel at :     1-888-888-3113.

My Name is_________________________ How did you hear about Clear?
I would like to refer a friend or family member: _______________________
Referral phone number: _________

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