AT&T RESIDENTIAL LONG DISTANCE SERVICE APPLICATION

By submitting this form, you are authorizing AT&T to process your application and to notify Innovative, your local telephone company, about your decision to switch to AT&T Long Distance Service. Your local telephone company may charge you to switch long distance companies. If so, AT&T will reimburse you for this charge.

This application applies to the residential telephone number(s) listed herein. This selection will become null if in the future you change the number(s) indicated to another long distance company. I understand that there may be a charge per line by Innovative for any changes I make following this selection.