Cascade Communications Company 106 Taylor Street SE, PO Box 250 Cascade, IA 52033-0250

Authorization for Changing Long Distance Carriers

I authorize Cascade Communications Company to change my Interlata and Intralata Long Distance Carrier to Cascade Communications Company Long Distance. I understand there may be a fee for switching my long distance carrier.

I request the following plan:
_______________________________ $0.14 per minute plan (3A)
_______________________________ $0.10 per minute plan / $3.95 monthly fee (4A)
_______________________________ 800 number plan
(Rates are subject to change)


My telephone number(s) to be switched are: _____________________________
_____________________________

Signature: _______________________________________________________
Date: __________________________________________________________