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ATC Long Distance Letter of Authorization In order to sign up for long distance service with ATC Long Distance, please choose a plan and sign this form which authorizes us to switch your long distance carrier to ATC Long Distance. All per minute charges are for 24 hours a day seven days a week. In-State calls are those in the state of Idaho and Out-of-State calls are those from Idaho to another state within the contiguous United States. Instate & Out-of State Plans Combined ___Plan 1: In-State 12¢ a minute and Out-of State 5¢ a minute with a $6.95 monthly surcharge. ___Plan 2: In-State 12¢ a minute and Out-of State 7¢ a minute with a $4.95 monthly charge. ___Plan 3: In-State 12¢ a minute and Out-of-State 10¢ a minute with with no monthly charge. In-State Plan Only ___Plan 1: In-State 15¢ a minute. Out-of-State Plans Only ___Plan 1: Out-of-State 15¢ a minute. ___Plan 2: Out-of-State 10¢ a minute with a $4.95 monthly charge. 800 Number ___800 Number: In-State and Out-of –State 15¢ a minute with a $2.00 monthly charge. Calling Card ___Calling Card: In-State and Out-of-State calls 23¢ a minute with a 35¢ surcharge. Payphone surcharge 40¢. Telephone number(s) that you would like switched to ATC Long Distance. __________ __________ __________ __________ __________ __________ __________ Terms of Authorization I certify that I am at least 18 years of age. The phone number(s) listed on the authorization are listed in my name and/or I am authorized to change the long distance service. My submitting this form authorizes ATC Long Distance to act as my agent to notify my local telephone company of my decision to change from my current long distance service to ATC Long Distance service. I understand my local telephone company may charge me a one time nominal fee for each telephone number switched. Selection of ATC Long Distance will apply to the telephone number(s) listed on this form. Printed Name:____________________________Signature__________________________________ (Required) Rates, Terms and Conditions of Service The rates, terms and conditions governing the provisions of our interstate long distance services are set forth in our Rates, Terms and Conditions of Service document which will be available for your inspection at our business office located at 225 West North Street Albion, ID during normal business hours. This information will also be available on our website at www.atccomm.com. Your access and use of our Interstate long distance service represents acceptance of the rates, terms and conditions set forth in the Rates, Terms and Conditions of Service document. We will provide you with advance notification of changes in the document through either a bill insert or direct mail.
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