REQUEST TO TRANSFER CUSTOMER RESPONSIBILITY



REQUEST TO TRANSFER CUSTOMER RESPONSIBILITY ____________________

(ACCOUNT NUMBER)

SUPERSEDURE AGREEMENT

________________(Outgoing Customer) and _______________ (Incoming Customer) authorize change in responsibility for invoices rendered on the account number shown above, effective on _____________(enter date), provided this form is properly completed, signed and received. Incoming Customer is subject to all Sprint Nextel credit approvals and procedures. Any applicable deposit and/or delinquent charges must be paid in full or other arrangements satisfactory to Sprint Nextel must be made before an account can be transferred. The outgoing Customer must authorize in writing the release of any account information prior to the effective date of transfer before Sprint Nextel will provide information on the customer account to the Incoming Customer.

Sprint Nextel is released and held harmless from any loss, damage and liability that may result from this account change and any rejection cancellation or revocation of this request. Supersedure agreement will take effect at the end of a billing cycle only. No prorated charges will be calculated.

Outgoing Customer may discontinue service or revoke this account transfer by written request delivered to Sprint Nextel anytime prior to the effective date of transfer. Incoming Customer may revoke this request by written request delivered to Sprint Nextel anytime prior to the effective date of transfer. Incoming Customer is responsible for notifying Outgoing Customer of any such cancellation.

THIS REQUEST MAY BE REJECTED BY SPRINT NEXTEL AND/OR SERVICE MAY BE DISCONNECTED BY SPRINT NEXTEL IF ALL ACCOUNT BALANCES ARE NOT PAID IN FULL. IN ORDER TO BECOME EFFECTIVE ON THE DATE SET FOR THE ABOVE, THIS FORM MUST BE COMPLETED AND RETURNED BY ____________(DATE).

TO BE COMPLETED AND SIGNED BY THE OUTGOING CUSTOMER

_______________________________________

Customer Name

_______________________________________

Street Address

_______________________________________

City, State, Zip Code

_______________________________________

Telephone Number

I understand that all charges through __________(enter end of the month of the effective date above) must be paid prior to transfer. Transfer will take effect at the end of a billing cycle only. No prorated charges will be calculated. Incoming customer’s assumption or responsibility for account balances does not relieve me of my responsibility for those balances if they are not paid.

I assume full responsibility to notify the Incoming Customer should I elect to cancel the pending Request to Transfer Customer Responsibility and/or disconnect service. Outgoing Customer is responsible for notifying Incoming Customer of any such cancellation.

_______________________________________

Authorized Signature (Outgoing Customer)

_______________________________________

Title

_______________________________________

Name

_______________________________________

Date

_________(initial here) to authorize Sprint Nextel to disclose to the Incoming Customer all services currently being provided under the charges being billed and all outstanding account balances for the account.

TO BE REVIEWED AND SIGNED BY THE INCOMING CUSTOMER

Beginning on the first day of the next billing cycle following the effective date of transfer shown above, I will be responsible for all bills rendered on this account. Please send all bills rendered on or after the effective transfer date to the following address:

_______________________________________

Customer Name

_______________________________________

Street Address

_______________________________________

City, State, Zip Code

_______________________________________

Telephone Number

This transfer will not occur until all charges owed by the Outgoing Customer are paid or assumed by me.

_____________I agree to assume the outstanding balance on this account and responsibility for all charges on this account.

The one time charges to transfer this account is $_____________

_______________________________________

Authorized Signature (Incoming Customer)

_______________________________________

Title

_______________________________________

Name

_______________________________________

Date

____________(initial here) I request an itemization of monthly charges for services currently being billed and account balances on this account. This disclosure may cause a delay in the effective date.

Credit Form KLD050103

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