SkyPhone - Northwest Communications

Skyphone - 911 Agreement

ACKNOWLEDGEMENT, VOICE OVER INTERNET PROTOCOL (VOIP), & ENHANCED 911 SERVICE

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Skyphone - E911 NOTIFICIATION. ALL USERS(CUSTOMER) OF SKYPHONE/NORTHWEST COMMUNICATIONS INC’S SESSION INITIATION PROTOCOL (“SIP”) BASED VOICE OVER INTERNET PROTOCOL (“VOIP”) SERVICES ARE REQUIRED TO AGREE THAT THEY HAVE READ AND UNDERSTOOD THE LIMITATIONS LISTED BELOW ASSOCIATED WITH THE 911 AND E-911 EMERGENCY SERVICES AVAILABLE THROUGH SKYPHONE/ NORTHWEST COMMUNICATIONS INC. IF THEY HAVE NOT READ OR DO NOT AGREE, THEY ARE NOT AUTHORIZED TO USE ANY OF SKYPHONE/NORTHWEST COMMUNICAITONS CALLING SERVICES. The 911 calling capabilities associated with VOIP calling services is different from those offered by traditional analog telephone services. Skyphone/Northwest Communication’s VOIP calling services are not meant to be relied upon in the case of an emergency. While SKYPHONE/Northwest Communications Inc. attempts to provide access to emergency service, these VOIP services are not intended to be used to support or to carry emergency calls to any type of hospitals, law enforcement agencies, medical care units, alarms or any other kind of emergency services. CUSTOMER SHOULD MAINTAIN ALTERNATVIE MEANS OF CALLING EMERGENCY SERVICES SUCH AS ANALOG OR CELLULAR SERVICE. Electrical outages and internet connectivity problems, including network congestion, may disrupt Skyphone/Northwest Communication’s calling service and prevent 911 emergency calling. Service disconnects due to account suspensions, billing issues, or any other reason will prevent 911 emergency calling. VOIP services are technically capable of being used in locations that are not associated with the traditional geographic area of a telephone number. These capabilities can cause 911 problems. All 911 capabilities will only be available in the locations that CUSTOMER has associated with the Skyphone/Northwest Communication assigned direct-inward-dial (“DID”) telephone number assigned to the CUSTOMER. For e911 to be accurately routed to the appropriate emergency call center, the CUSTOMER must provide accurate DID telephone numbers as the call-back telephone number for all 911 calls and accurate address information. Additionally, using the service in a location that uses a different area code than the area code of the DID number provided may not be able to reach emergency personnel or may not reach emergency personnel near customer’s actual physical location. Failure to provide a correct physical address in the correct format may cause 911 emergency calls to be routed to the incorrect local emergency service provider. Use of Skyphone/Northwest Communications’ VOIP calling service from a location other than the location which such service was registered may result in 911 emergency calls being routed to the incorrect local emergency service provider. Changes of location submitted to Northwest Communications, or a Skyphone/Northwest Communications partner, reseller or agent may take up to 48 hours to be reflected accurately in E911 records.*

I understand the above

Your Name*

First Last

Your Address*

Street Address Address Line 2 City ZIP Code

Date*

Customer Number*

Signature*

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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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