New Search
vedzprwireiess <br />Please refer to Corporate Liable Authorization Form Instructions. Please complete this form and return it to Verizon Wireless via e-mail by saving a copy to <br />your desktop and sending it as an attachment to: POCUDdatesOVerizonWireless mm <br />The person signing this form represents and warrants that they have the authority to bind the Company /Customer identified below and requesting that <br />Verizon Wireless add /delete Authorized Contacts as noted below. If returning via e-mail please type name. <br />Company Name fil <br />' A_/ <br />Sig nature: _ Date: r <br />Company Address:' <br />Name: ,j � <br />City: State: <br />f Z ZIP: <br />1 D� <br />t?' <br />_ <br />3 E <br />Title: 1 ! 1 .� - wa.., � 0 �1ni.._< .�.:.. <br />Fed. Tax ID <br />&B # <br />Contact Phone Number: ( C.(% 9 A 4 ` <br />Contact E -mail <br />C a <br />. <br />Do you want to add yourself as an Authorized Point of Contact? Check this box if YES. <br />If YES, Please designate your Role: <br />Please enter the Account Number and /or a Mobile n umber for company: <br />0 <br />To maintain flexibility for your business, the above changes will not impact your My Business online portal authorized <br />personnel. Please access the self serve portal directly to make changes to your online portal authorized personnel. <br />Page 2 of 2 <br />