To sign up for SugaDog Long Distance Service, please read the customer Authorization and submit the Letter of Agency Listed below. Please remember that you must be authorized to make changes on your local telephone service.

Authorization:  I hereby request that all PIC restrictions be removed and authorize Indiana Telephone Network to provide long distance service for the telephone numbers listed below and those attached to this Letter of Agency (LOA).  I also authorize Indiana Telephone Network to notify my local carrier of this choice and I understand this will change my long distance provider.  I understand that  my state may allow another primary interexchange carrier for intraLATA long distance.  I hereby authorize Indiana Telephone Network to select my intraLATA long distance carrier.  I understand that my local carrier may charge a PIC fee for each line that is changed.  In the event that this account becomes delinquent, I hereby agree to pay all related costs, including interest, fees and third party collection costs. You may confirm that your services have been changed to ITN by calling 1-888-272-6525

Full Name

Date of Birth

Service Address

City

State

Zip Code

Main Telephone Number

Please Add Service To My Main Line

To My Second Line

To My Third Line

Would You Like an 800 Number?

800 Number Directed To

Would You Like a Calling Card?

Calling Card PIN # (must be 4 digits)

Authorized Customer Signature

Date