Corporate to Corporate Assumption of Liability
This form will aid you in transferring billing responsibilities for a Verizon Wireless mobile telephone number currently held by one company to another.
1) Complete all the applicable fields in the appropriate sections below.
2) If you are eligible or required to change your calling plan (i.e. line being assumed is on a Family SharePlan), review the available calling plans on the Verizon Wireless website at www.verizonwireless.com. After selecting a calling plan, complete the fields in the Calling Plan Selection section below.
3) Read the terms and conditions of the Transfer of Billing Responsibilities section.
4) Read the Verizon Wireless Customer Agreement. You may obtain a copy of the Customer Agreement from your Company Representative or online at http://www.verizonwireless.com/b2c/footer/customerAgreement.jsp.
5) If you are returning this form via Fax, sign on the signature line. Fax this form to 678-339-7631
6) If you are e-mailing this form, click the box to the left of the signature line and email it to . Emails will only be accepted from the employer email domain. If unable to send from the employer email domain, the form should be faxed.
Complete this Section for the Corporate to Corporate Assumption of Liability
Wireless Number to be Transferred: / Existing Account Number:
Existing Company Name: / Add to my Existing Account Number: (If applicable)
Assuming Company Name: / Assuming Company Tax ID Number:
Billing Address: (Physical address required for credit check, may use PO Box for billing) / Name and Title of Assuming Company Representative (Must be listed as an authorized signor for the company)
City: / State: / Assuming Company Representative’s Telephone Number
Calling Plan Selection
Note: Eligibility for access discounts may vary by calling plan and access amount.
Complete all the applicable fields: / Select a calling plan for the remaining line(s):
Calling Plan Monthly Access: / Calling Plan Monthly Access:
Monthly Home Airtime Minutes: / Monthly Home Airtime Minutes:
Promotions: / Promotions:
Transfer of Billing Responsibilities Terms and Conditions
Corporate to Corporate Assumption of Liability (line still eligible for business discount if applicable)· Company must submit to credit verification and initiate an Agreement of Service with Verizon Wireless, if not previously in existence.
· Liability for billing and all other rights in each mobile telephone number will not transfer from Company to Company until processing by Verizon Wireless is complete. (normal processing time is 3-5 business days). Company remains liable for all charges associated with each mobile telephone number until transfer of liability is completed.
· Once the assumptions of liability described herein are completed, Company shall be solely responsible for all obligations associated with the assumed mobile telephone numbers, subject to the terms and conditions of its existing agreement with Verizon Wireless.
· If Company subsequently terminates any mobile telephone number that is not transferred; it may be liable for an Early Termination Fee as provided in its Agreement with Verizon Wireless.
· The Transfer of Liability Authorization is subject to the Terms and Conditions of the Agreement between Company and Verizon Wireless.
By signing this form, or clicking the box to the left, I understand and agree to the terms and conditions above. I agree to assign liability for the mobile telephone number indicated above.
Note: Your employer has separately agreed to assume liability for this mobile telephone number.
Assuming Company Representative’s Name / Date