LIGHTSTREAM BUSINESS APPLICATION Date

LIGHTSTREAM BUSINESS APPLICATION Date:

Customer Information

Account Name: Service Address: City:

Federal ID or SS #:

State:

Zip:

Mailing Address (if different): City:

Suite/P.O. Box:

State:

Zip:

Contact Name: Phone Number:

Email Address:

Directory Information

Listed/Published (in phone book and available from directory assistance) Print Desired Listing Description:

Non-Listed (not in phone book, but available from directory assistance) ($0.50/mo.) Non-Published (not in phone book or available from directory assistance) ($0.50/mo.) Additional Listing ($0.50/mo.)

Telephone Options

Number of Phone Lines Desired:

Fax Line:

Long Distance Carrier:

Calling Features:

Inside Wire Maintenance ($0.50/mo.):

Yes

No

Pic Freeze:

Yes

No

Collect Call Block

International Block

900 Block

3rd Party Block

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LIGHTSTREAM BUSINESS APPLICATION

LightStream Internet

Please print form and return to: CL Tel, 107 N. 4th Street, Clear Lake, IA 50428

Or email PDF to: cltel@

50 Mbps / 25 Mbps

(with 3-year contract)

50 Mbps / 25 Mbps

(no contract)

100 Mbps / 50 Mbps

(with 3-year contract)

100 Mbps / 50 Mbps

(no contract)

200 Mbps / 100 Mbps

(with 3-year contract)

200 Mbps / 100 Mbps

(no contract)

$59.95 $79.95 $99.00 $174.95 $179.95 $299.95

500 Mbps / 250 Mbps

(with 3-year contract)

500 Mbps / 250 Mbps

(no contract)

1Gig / 500 Mbps

(with 3-year contract)

1Gig / 500 Mbps

(no contract)

$399.00 $599.95 $899.00 $1195.95

Static IP Address(es): Yes

No

Free Email Address:

@

Password:

Free Email Address:

LightStream TV

Number of TVs to be connected:

@

Password:

Pick One: Other:

LightStream Enhanced

LightStream Ultimate

Digital Video Recorder (DVR) Showtime/Flix/TMC/Sundance

HBO

Cinemax

Starz!/Encore

The undersigned requests Clear Lake Independent Telephone Company to furnish the exchange telephone service and facilities indicated above. For such service and facilities furnished upon this request and for any toll service furnished at applicant's telephone number or numbers, the undersigned agrees to pay the rate lawfully in effect. This is subject at all times to the general "Rules and Regulations" applying to telephone service on file in the local office of the Telephone Company. The undersigned has been informed of the lowest rate available* and the ability to block 900 number dialing. In the event this number becomes delinquent, all other numbers for which the applicant is responsible could also be disconnected.

Signature:

Date:

*Our lowest rate is: Touch Tone Access Line ? $22/month for single line business. Other required monthly line fees: Interstate Access Charge (IAC & ARC) -- $9.50, 911?$1, FUSC (based on federal charges on CL Tel bill).

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