Cable TV Agreement - old
What residential services are you requesting?:
Applicant:: Applicant Birth Date:: 01-01-1970
Will You have a Co-Applicant?:
Co-Applicant:: Co-Applicant Birth Date::
City:: State:: Postal Code: :
Is your Billing Address the same Service Address?:
Billing Address: :
Billing City: : Billing State: : Billing Postal Code: :
Applicant Phone: : Applicant Phone: :
Select the Cable TV Package
Cable Card Lease - $6.99/mo: Premium Options:
Video Prepayment (Activation of Service: $49.99 plus first month)
(We will call you to collect the prepayment once we receive your application.)
Prices do not reflect applicable taxes, franchise fees & other mandated service charges. Excitement, Music and Premium options all require a customer owned set-top box and a cable card lease.
Lakeland Communications and its subsidiaries are not responsible for any associated components, e.g. Surround sound, VCR's DVD's, DVR's etc.. and therefore have no liability. Lakeland does not take any responsibility for force majeure, electrical, power surges or lightning damage. We require that the customer use an electric surge protctor with their digital cable service.
The package fee is billed one month in advance. Activation & package fee due before service is installed. Activation Fee: $50
Includes: Activiation at Ped. Signal to NID. (Activation does not include any wiring). Any additional consultation time will be billed at $80.00 per hour plus materials. After the Initial activation, any work, wiring or maintenance done at the customer premise will be billed at $80.00 per hour, material and wiring charges, along with a $50.00 Dispatch Fee. Upgrades to digital connection cords can be purchased at time of installation from Technicaian.
ANNUAL REGULATORY NOTICE
900 CALLING/BLOCKING SERVICE
The following consumer rights for Pay Per Call 900 service are provided under the Federal Telephone Disclosure and Dispute Resolution Act. For billing error claims regarding 900 service charges: Call the number on your bill listed with the 900 charges within 60 days of receiving the bill. Oral notification is sufficient to begin a billing review. Payment of disputed 900 service charges is not required during the review period. Written acknowledgment of your dispute must be provided to you within 40 days of receiving your notice if: The error has not been corrected or the billing review is not completed. The billing review must be completed within 90 days and, an explanation must be provided to you if the bill was correct or the error must be corrected. If the bill was found to be correct: You have the right to request a written explanation. You should receive a written notice of the amount you owe and the payment due date. If you fail to pay the amount that you owed, you may be reported as a delinquent, but, the name and address of any party to which you were reported delinquency must be provided to you. If you do not agree with the explanation and if you so give notice before the payment due date, any delinquent report must state that you still dispute the charges. Any party receiving the delinquent report must also be advised in writing when the matter is settled. If the above rules are not followed, the first $50 for each 900 service charge in question cannot be collected even if your bill was correct. Collection of unpaid 900 charges may be pursued by the Inter-exchange Carrier or Information Provider through an independent collection action. Non-payment of 900 service charges or charges for similar types of service will not result in disconnection of your local or long distance service. However, access to 900 numbers may be blocked for non-payment of legitimate charges. You should not be billed for 900 services that are not offered in compliance with federal laws and regulations. You may obtain blocking of 900 services at no charge by calling your local telephone customer service center at 715-825-2171 or 715-472-2101. RESTRICT UNWANTED TELEPHONE SOLICITATIONS
In 2003, the Do-Not-Call Act was signed into law. This legislation allowed for the establishment and enforcement of a national Do-Not-Call Registry giving consumers a choice regarding telemarketing calls. If your number is listed on the registry, all commercial telemarketers, except for businesses with whom you have an existing relationship or certain non-profit and political organizations, are not allowed to call you. Consumers may register their residential telephone number, including wireless numbers, on the national Do-Not-Call Registry by telephone or by Internet at no cost. You can register on-line for the national Do-NotCall Registry via the internet at www.donotcall.gov . Inclusion of your telephone number on the national DoNot-Call Registry will be effective 31 days after registration. Your number will remain on the registry permanently. You are allowed to remove your number from the registry at any time. If you continue to receive telemarketing sales calls or robocalls, you can file a complaint by visiting www.donotcall.gov , or by calling 1888-382-1222 (TTY 1-866-290-4236). REGULATION OF TELEPHONE SOLICITATIONS
If you are engaged in making telephone solicitations, you should be aware of the requirements of the national Do-Not-Call rules and regulations. The relevant federal do-not-call rules are set forth in 47.C.F.R. s. 64.1200 and 16 C.F.R. Part 310, respectively. This notification is being provided as a reminder of your obligations under the above federal do-not-call rules. For additional information, you may contact the Federal Communications Commission at 1-888-225-5322, on the Internet at www.fcc.gov or via email to email@example.com. STATEMENT OF NONDISCRIMINATION
“In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, religion, age, disability (Not all prohibited bases apply to all programs.) To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, DC 20250-9410, or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.” LIFELINE PROGRAM
Universal Service Fund low-income lifeline program is available to recipients of Food Stamps, Medicaid, SSI, Veteran’s Pension Benefits, Badger Care, Wisconsin Works (W2), Tribal Lands or the Wisconsin Homestead Tax Credit. Consumers must be active clients in the applicable state databases. The local telephone company has established an agreement with the Wisconsin Department of Workforce Development (DWD) that allows them to verify eligibility through DWD. The Public Service Commission has established an agreement with the Wisconsin Department of Revenue that allows DOR, with signed release from the customer, to provide a telephone company with verification of eligibility through receipt of the Wisconsin Homestead Tax Credit. A consumer may also be eligible for Lifeline assistance if that consumer’s income is below 135% of the Federal Poverty Level. The USF Lifeline Program is not available to customers who are dependents for federal income tax purposes unless the customer is more than 60 years of age. With recent Federal Communications Commission (FCC) reforms, the Lifeline program has been streamlined, and eligible customers are now limited to one wireline or wireless phone or Broadband Internet Access Service (BIAS) per qualified household. LIFELINE ASSISTANCE:
Lifeline provides a reduced monthly rate for telephone and BIAS service (subject to speed tier minimums). Local telephone companies must meet certain requirements before they can offer this program. Contact with a local telephone company will have to be made to verify the availability of this program in a particular area of the State. For those telephone companies who meet the requirements, funding is available for monthly telephone and BIAS charges. Tribal Land customers may also be eligible for link-up discounts. If you have questions in regards to the above mentioned program, please contact our office at 715825-2171 or 715-472-2101. CUSTOMER PROPRIETARY NETWORK INFORMATION PRIVACY NOTICE.
It is Lakeland Communication’s responsibility under federal law to protect the confidentiality of your Customer Proprietary Network Information (CPNI). CPNI is any information that is not publicly available and includes the type of phone service you receive from Lakeland Communications, number of lines, amount of usage and calling detail. As a customer, you have the right at any time to restrict the use of CPNI for marketing purposes. If you choose not to permit us to disclose your CPNI with Lakeland Communications and our affiliates, you may opt-out of receiving such information. The services you are currently receiving will not be affected if you optout, however, restricting CPNI may make you ineligible to receive information from Lakeland Communications and our affiliates about new products and services, packaged offerings and various promotions. If you DO NOT want us to share your CPNI with Lakeland Communications and our affiliates you can call our business office at 715-825-2171 or 715-472-2101 within thirty (30) days. Once you opt-out you will remain on this list until you request otherwise. BASIC TELEPHONE SERVICE FROM YOUR LOCALLY OWNED TELEPHONE COMPANY LAKELAND COMMUNICATIONS
Lakeland is designated as an Eligible Telecommunications Carrier by meeting the guidelines of the Federal Communications Commission and the Wisconsin Public Utilities Commission. Basic Telephone from Lakeland includes: Single party service including unlimited local calling minutes; touch-tone service; voice grade access to the public switched network; access to emergency services (including 911 and enhanced 911); access to operator assistance; inter-exchange carriers and directory assistance. Low income individuals may be eligible for Lifeline and Tribal Lands for Lifeline and Link-up telephone assistance programs, which provide discounts from these basic rates. Also available to Lifeline customers, as well as all of our customers, is toll blocking which lets customers block outgoing long distance calls free of charge. If you have any questions please contact Lakeland at 715-825-2171 or 715-472-2101 or you may stop at our business office: Lakeland Communications, 825 Innovations Ave., P.O. Box 40 Milltown, WI or 28 1st. Ave. W. Luck, WI.
I understand and have read this application. I will abide by this application for service. Programming fees will increase as incurred.
I have read and I understand all of the above.
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Signed by Lakeland Communications
Signed On: August 4, 2020
If you have questions about the contents of this document, you can email the document owner.
Document Name: Cable TV Agreement - old
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