wpesig-user-profile

CUSTOMER CPNI REQUEST FORM

Lakeland Communications

Final step. Click on "Agree & Finish” to finish signing.

Document complete.

1 of 1 page

I am and I agree to be legally bound by this agreement and WP E-Signature Terms of Use.

NEXT

CUSTOMER CPNI REQUEST FORM


Lakeland Communications
825 Innovation Ave.
P.O. Box 40
Milltown, WI 54858
715-825-2171

 

Due to FCC mandated regulations, our customers’ proprietary information will be restricted, which safeguards our customers’ accounts while providing protection to the customer and to Lakeland. Customer Proprietary Network Information (CPNI) includes things like, but not limited to: current charges and services, balances and payments, calling patterns, usage, etc. Please fill out the information below and return to our office.

 

Account #:  

Account Holders name:  

Date of birth:  

Service Address:  

Billing Address (if different):  

Telephone Number:  

Email Address:  

CPNI Password (4-16 alpha or numberic characters):  

Recovery Password Questions

Mothers maiden name:  

Name of first pet:  

These people may obtain CPNI from my account (if desired):  

Date:

 

Note: Lakeland Communications may call your telephone number of record once this form is received to verify the accuracy of this request.

Please Review & Sign This Document

wpesig-user-profile

CUSTOMER CPNI REQUEST FORM

Lakeland Communications

Please review the document below

You're done signing! CUSTOMER CPNI REQUEST FORM

Terms of Use

Loading terms of use...