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Customer Name:

Address:

Street AddressCity

Type of Install:

Installed Cordless Phone(s)

Connected to Existing IW

Business - See AVS service addendum

Did Customer Purchase Phones from us?

Yes

No

Number of Phones:

ATA MAC (Last 5 Digits):

Date of Install:

Install Techs:

Drew Eurich

Drew Galleck

Justin VanValkenburgh

Rob Neal

Travis Kuhl

Shane VanValkenburgh

Brian Dorsch

Mason Pasek

Butch Baker

Tech Team (names in notes)

Comments:

Word Verification:

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