Customer Privacy Information - Northwest Communications

CUSTOMER PRIVACY INFORMATION FOR CUSTOMER

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Effective December 8, 2007, The FCC has implemented new rules to protect the privacy of information contained in your telephone account with Skyphone AKA Northwest Communications Inc. The new rules allow us to discuss account information only with the person(s) listed on the account. Also, we must be able to authenticate that person and will do that by having you establish a password. To establish the password, please call our office and we will ask you to provide us with the PIN# listed below. After we have authenticated you with the PIN#, you will be able to establish a password and back-up authentication question. If you come into the office, you will be required to show a photo ID.*

Account Phone Number*

If your account is listed in only your name, you might want to consider adding another name, if appropriate such as a spouse or roommate. If you are a parent of individual that relies on someone else to discuss account changes, payment, or anything else with our company, you will need to have that person’s name added to your account. The name will not need to be added to billing name but can be added to our records as an authorized person for discussing information and making changes to your account. The additional contact(s) that you authorize will not be responsible for payment of this account or entitled to any of the capital credits or voting privileges associate with this account. After you have established your password with us, you will need to provide the password to the other authorized contacts on this account.*

No, I do not want to add any additional authorized contacts to my account.

Yes, I would like to add the following as authorized contacts for my account.

If Yes, List name/names being added:

If you would like to use a security questions in the case you do not have your PIN# with you may create one. (Please do NOT use a question that unauthorized people can easily know the answer to.) This is information that you will know but not general knowledge. If you wish to add, a question please complete area below to add question and answer.*

Please type Security Question.

Answer*

Authorized by*

Date*

Signature*

THIS FORM MUST BE RETURNED IN ORDER TO ACCESS YOUR ACCOUNT INFORMATION IN THE FUTURE PLEASE KEEP A COPY FOR YOUR RECORDS If you have any questions, please call our office at 712-776-2222 or dial 611 from your home phone.

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