| CMTEL PIC Freeze | ||||||||||
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I would like to place a Preferred Carrier Freeze on the following services and telephone numbers: Name: ______________________________________________________________ Address:_____________________________________________________________ Telephone Number[s] covered by Freeze: ____________________________________
Signature: _________________________________Date: ______/_______/_______ If you have additional telephone numbers that you want frozen, please list them here: Additional Number: ________________________________________ Additional Number: ________________________________________ Additional Number: ________________________________________ Additional Number: ________________________________________ Additional Number: ________________________________________
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