Company

*Name

*E-mail

*Phone

*911 Location - Street Address

*911 Location - City

*911 Location - State - Select a State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

*911 Location - Zip Code

Terms of 911 Activation: I am authorized to update and/or change the location information for the above number. I understand that it is my responsibility to verify that I have entered the correct location information. I understand that 911 services will not work in the event of a power or Internet outage and have made other arrangements to dial emergency services in the event that my IP phone service is interrupted. I understand that I must update my location information 48 hours prior to moving my equipment to a new location. I understand that my 911 service may not be activated prior to receiving email or written confirmation that my service is activated. I understand that it is my responsibility to update all persons including guests of the limitations of dialing 911 emergency services. These limitations include but are not limited to power or Internet outages and enhanced 911 availability. I understand that enhanced 911 may or may not be available for my number. If enhanced 911 is not available, I understand that I must be prepared to provide my address and phone number when dialing 911. Furthermore, I understand that I must notify all persons and guests of this limitation. If enhanced 911 is not yet available in my region, I will affix a label to each telephone displaying the address and phone number that must be given to the dispatcher when dialing 911.

*I agree to the "Terms of 911 Activation"