Port Consent Port Consent Business Name * Name * Name First First Last Last Phone Number to be Ported to MyRepChat * Porting a number involves moving all features associated with a number to MyRepChat. If you are porting a Cellular Number to MyRepChat, a support specialist will reach out to verify a few items before initiating the port. Users Email Address used for your MyRepChat Account * Account Number at Losing Carrier PIN Provided by Losing Carrier Current telephone provider associated with this number: * Type of number to be ported? * LandlineVoice Over Internet Protocol (VOIP)CellularUnsure If user is requesting more number, please enter them here separated by "," Address associated with this number * Address associated with this number Street Street Address associated with this number City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal TERMS AND CONDITIONS By signing the below, I verify that I am, or represent (for a business), the above-named service customer, authorized to change the SMS carrier(s) for the telephone number(s) listed, and am at least 18 years of age. The name and address I have provided is the name and address on record with my local telephone company for each telephone number listed. I authorize ionlake, LLC., or its designated agent to act on my behalf and notify my current carrier(s) to change my SMS carrier(s) for the listed number(s) and service(s), to obtain any information ionlake, LLC. deems necessary to make the carrier change(s), including, for example, an inventory of telephone lines billed to the telephone number(s), carrier or customer identifying information, billing addresses. Consent * I have read, understand, and voluntarily agree to take part in this training. Participant's Signature * signature keyboard Clear Date * Captcha Submit Start Over If you are human, leave this field blank.
