Existing Frontier Customer with New DIRECTV 1 Sales Rep Info2 Customer information3 Frontier High Speed Internet 4 Frontier Voice Product5 DIRECTV6 Promotions7 Notes8 Order Summary Sales Rep* First Last Sales Rep Phone*Sales Rep Email:* Sales Manager Email:* Business Name*Customer Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone*Cell PhoneFile*-Upload Letter of Agency -Upload Order Form -Upload Phone Bill & Internet Bill Drop files here or Frontier High Speed Internet Fios DSL Fios*With PhoneStand AloneDSL*With PhoneStand AloneWith Phone*Existing Fios With Phone < 75M/75M - $52Existing Fios With Phone < 100M/100M - $67Existing Fios With Phone < 200M/200M - $87Existing Fios With Phone < 300M/300M - $107Existing Fios With Phone < 500M/500M - $127Existing Fios With Phone < 700M/700M - $195Existing Fios With Phone < 1G/1G - $272Stand Alone*Existing Fios Stand Alone < 75M/75M - $95Existing Fios Stand Alone < 100M/100M - $110Existing Fios Stand Alone < 200M/200M - $130Existing Fios Stand Alone < 300M/300M - $150Existing Fios Stand Alone < 500M/500M - $170Existing Fios Stand Alone < 700M/700M - $240Existing Fios Stand Alone < 1G/1G - $315Frontier Billing Account #4 Digit Code*Frontier Billing Account #DSL With Phone*NoneExisting - DSL With Phone 1M/128K - $50Existing - DSL With Phone 3M/384K - $50Existing - DSL With Phone 6M/512K - $50Existing - DSL With Phone 9M/1M - $50Existing - DSL With Phone 12M/1M - $50Existing - DSL With Phone 18M/1M - $55Existing - DSL With Phone 25M/2M - $55Existing - DSL With Phone 35M/2M - $60Existing - DSL With Phone 45M/3M - $65Existing - DSL With Phone 70M/3M - $70Existing - DSL With Phone 90M/5M - $80Existing - DSL With Phone 115M/7M - $90New - DSL With Phone 1M/128K - $30New - DSL With Phone 3M/384K - $30New - DSL With Phone 6M/512K - $30New - DSL With Phone 9M/1M - $30New - DSL With Phone 12M/1M - $30New - DSL With Phone 18M/1M - $35New - DSL With Phone 25M/2M - $35New - DSL With Phone 35M/2M - $40New - DSL With Phone 45M/3M - $45New - DSL With Phone 70M/3M - $50New - DSL With Phone 90M/5M - $60New - DSL With Phone 115M/7M - $70DSL Stand Alone*NoneExisting - DSL Stand Alone 1M/128K - $75Existing - DSL Stand Alone 3M/384K - $75Existing - DSL Stand Alone 6M/512K - $75Existing - DSL Stand Alone 9M/1M - $75Existing - DSL Stand Alone 12M/1M - $75Existing - DSL Stand Alone 18M/1M - $80Existing - DSL Stand Alone 25M/2M - $80Existing - DSL Stand Alone 35M/2M - $85Existing - DSL Stand Alone 45M/3M - $90Existing - DSL Stand Alone 70M/3M - $95Existing - DSL Stand Alone 90M/5M - $105Existing - DSL Stand Alone 115M/7M - $115New - DSL Stand Alone 1M/128K - $35New - DSL Stand Alone 3M/384K - $35New - DSL Stand Alone 6M/512K - $35New - DSL Stand Alone 9M/1M - $35New - DSL Stand Alone 12M/1M - $35New - DSL Stand Alone 18M/1M - $40New - DSL Stand Alone 25M/2M - $40New - DSL Stand Alone 35M/2M - $45New - DSL Stand Alone 45M/3M - $50New - DSL Stand Alone 70M/3M - $55New - DSL Stand Alone 90M/5M - $65New - DSL Stand Alone 115M/7M - $75Frontier Phone Number*Frontier Phone Number*4 Digit Code*4 Digit Code*Total $0.00 Pots Lines With Internet Stand Alone # of POTS With Internet Lines*012345678910# of Stand Alone Lines*012345678910Line 1 - POTS*(Existing) Phone with Internet - $50Line 2 - POTS*(Existing) Phone with Internet - $50Line 3 - POTS*(Existing) Phone with Internet - $50Line 4 - POTS*(Existing) Phone with Internet - $50Line 6 - POTS*(Existing) Phone with Internet - $50Line 7 - POTS*(Existing) Phone with Internet - $50Line 8 - POTS*(Existing) Phone with Internet - $50Line 9 - POTS*(Existing) Phone with Internet - $50Line 10 - POTS*(Existing) Phone with Internet - $50Line 1- VOIP*(Existing) Phone Stand Alone - $60Line 2- VOIP*(Existing) Phone Stand Alone - $60Line 3- VOIP*(Existing) Phone Stand Alone - $60Line 4- VOIP*(Existing) Phone Stand Alone - $60Line 5- VOIP*(Existing) Phone Stand Alone - $60Line 6- VOIP*(Existing) Phone Stand Alone - $60Line 7- VOIP*(Existing) Phone Stand Alone - $60Line 8- VOIP*(Existing) Phone Stand Alone - $60Line 9- VOIP*(Existing) Phone Stand Alone - $60Line 10- VOIP*(Existing) Phone Stand Alone - $60Total $0.00 DIRECTV Referral AccountBusiness NameDIRECTV PromotionPrivate ViewingBusiness ViewingPublic ViewingResidential DIRECTVResidential DIRECTV with AT&T BundleResidential Swap to Commercial DIRECTVAuto Bill Pay*Auto Bill PayNo Auto Bill PayCredit Card NumberExpiration DateMM/YYYYCVVPromotion*1 Yr Promotion2 Yr PromotionPrivate Viewing 1 Yr ABP*Private Select - ABP ($74 / $20)Private Entertainment - ABP ($95 / $45)Private Xtra - ABP ($126 / $70)Private Optimo Mas - ABP ($88 / $37)Inform Customer That First Months Sales is HigherBusiness Viewing 1 Yr ABP*Business Select - ABP ($74 / $20)Business Entertainment - ABP ($95 / $45)Business Xtra - ABP ($126 / $70)Business Optimo Mas - ABP ($88 / $37)Inform Customer That First Months Sales is HigherPublic Viewing 1 Yr ABP*Public Select - ABP ($85/ $40)Public Entertainment - ABP ($125/ $75)Public XTRA - ABP ($200/ 100) + (RSF)Public Optimo Mas - ABP ($120/ $70)Public Mas Ultra - ABP ($145/ $85)Inform Customer That First Months Sales is HigherPrivate Viewing 1 Yr No ABP*Private Select - No ABP ($77/ $40)Private Entertainment - No ABP ($97/ $70)Private Xtra - No ABP ($139/ $100) + (RSF)Private Optimo Mas - No ABP ($92/ $65)Inform Customer That First Months Sales is HigherBusiness Viewing 1 Yr No ABP*Business Select - No ABP ($77/ $40)Business Entertainment - No ABP ($97/ $70)Business Xtra - No ABP ($139/ $100) + (RSF)Business Optimo Mas - No ABP ($92/ $65)Inform Customer That First Months Sales is HigherPublic Viewing 1 Yr No ABP*Public Select - No ABP ($85/ $55)Public Entertainment - No ABP ($125/ $100)Public XTRA - No ABP ($200/ $115) + (RSF)Public Optimo Mas - No ABP ($120/ $85)Public Mas Ultra - No ABP ($145/ $100)Inform Customer That First Months Sales is HigherPrivate Viewing 2 Yr ABP*Private Select - ABP ($74 / $37)Private Entertainment - ABP ($95 / $62)Private Xtra - ABP ($126 / $87)Private Optimo Mas - ABP ($88 / $54)Inform Customer That First Months Sales is HigherBusiness Viewing 2 Yr ABP*Business Select - ABP ($74 / $37)Business Entertainment - ABP ($95 / $62)Business Xtra - ABP ($126 / $87)Business Optimo Mas - ABP ($88 / $54)Inform Customer That First Months Sales is HigherPublic Viewing 2 Yr ABP*Public Select - ABP ($85/ $50)Public Entertainment - ABP ($125/ $85)Public Xtra - ABP ($200/ $130) + (RSF)Public Optimo Mas - ABP ($120/ $80)Public Optimo Mas Ultra - ABP ($145/ $100)Inform Customer That First Months Sales is HigherPrivate Viewing 2 Yr No ABP*Private Select - No ABP ($77/ $65)Private Entertainment - No ABP ($97/ $80)Private Xtra - No ABP ($139/ $115) + (RSF)Private Optimo Mas - No ABP ($92/ $75)Inform Customer That First Months Sales is HigherBusiness Viewing 2 Yr No ABP*Business Select - No ABP ($77/ $55)Business Entertainment - No ABP ($97/ $80)Business Xtra - No ABP ($139/ $115) + (RSF)Business Optimo Mas - No ABP ($92/ $75)Inform Customer That First Months Sales is HigherPublic Viewing 2 Yr No ABP*Public Select - No ABP ($85/ $65)Public Entertainment - No ABP ($125/ $100)Public Xtra - No ABP ($200/ $145) + (RSF)Public Optimo Mas - No ABP ($120/ $95)Public Optimo Mas Ultra - No ABP ($145/ $115)Inform Customer That First Months Sales is HigherResidential DIRECTV ABP*Select - $35Entertainment - $40Choice - $52XTRA - $62Ultimate - $67Premier - $117- Spanish Options -Optimo Mas - $35Mas Latino - $55Mas Ultra - $52Lo Maximo - $117Residential DIRECTV ABP*Select - $35Entertainment - $40Choice - $52XTRA - $62Ultimate - $67Premier - $117- Spanish Options -Optimo Mas - $35Mas Latino - $55Mas Ultra - $52Lo Maximo - $117Residential DIRECTV Bundle ABP*Select - $35Entertainment - $40Choice - $52XTRA - $62Ultimate - $67Premier - $117- Spanish Options -Optimo Mas - $35Mas Latino - $55Mas Ultra - $52Lo Maximo - $117Residential DIRECTV Bundle ABP*Select - $35Entertainment - $40Choice - $52XTRA - $62Ultimate - $67Premier - $117- Spanish Options -Optimo Mas - $35Mas Latino - $55Mas Ultra - $52Lo Maximo - $117Additional Receivers Price: $7.00 Quantity: Additional Receivers Price: $15.00 Quantity: Additional Receivers Price: $7.00 Quantity: Additional DVR Receivers*None1 DVR = $152 DVR = $223 DVR = $294 DVR = $36Only for Private viewing.Email* Driver's License #*Expiration Date*DOB*Social SecurityResidential DIRECTV No ABP*Select - $40Entertainment - $45Choice - $57XTRA - $67Ultimate - $72Premier - $122- Spanish Options -Optimo Mas - $40Mas Latino - $60Mas Ultra - $57Lo Maximo - $122Residential DIRECTV No ABP*Select - $40Entertainment - $45Choice - $57XTRA - $67Ultimate - $72Premier - $122- Spanish Options -Optimo Mas - $40Mas Latino - $60Mas Ultra - $57Lo Maximo - $122Residential DIRECTV Bundle No ABP*Select - $40Entertainment - $45Choice - $57XTRA - $67Ultimate - $72Premier - $122- Spanish Options -Optimo Mas - $40Mas Latino - $60Mas Ultra - $57Lo Maximo - $122Residential DIRECTV Bundle No ABP*Select - $40Entertainment - $45Choice - $57XTRA - $67Ultimate - $72Premier - $122- Spanish Options -Optimo Mas - $40Mas Latino - $60Mas Ultra - $57Lo Maximo - $122Email* Driver's License #*Expiration Date*DOB*Social SecurityContact Verification Department for AT&T & DIRECTV Bundle Price (prices may varies based of location) Call 1-888-915-0883 Ext 3Residential Swap to Commercial DIRECTV*Private ViewingBusiness ViewingPublic ViewingPrivate Viewing 1 Yr ABPBusiness Select - ABP ($77/ $25)Business Entertainment - ABP ($97/ $55)Business Xtra - ABP ($139/ $85) + (RSF)Business Optimo Mas - ABP ($92/ $50)Inform Customer That First Months Sales is HigherBusiness Viewing 1 Yr ABPBusiness Select - ABP ($77/ $25)Business Entertainment - ABP ($97/ $55)Business Xtra - ABP ($139/ $85)Business Optimo Mas - ABP ($92/ $50)Inform Customer That First Months Sales is HigherPublic Viewing 1 Yr ABPBusiness Select - ABP ($79 / $35)Business Entertainment - ABP ($121 / $78)Business XTRA - ABP (183 / 89)Business Optimo Mas - ABP ($113 / $58)Business Mas Ultra - ABP ($136 / $80)Inform Customer That First Months Sales is HigherPrivate Viewing 1 Yr No ABPBusiness Select - No ABP ($71 / $30)Business Entertainment - No ABP ($92 / $55)Business Xtra - No ABP ($125 / $71)Business Optimo Mas - No ABP ($85 / $30)Inform Customer That First Months Sales is HigherBusiness Viewing 1 Yr No ABPBusiness Select - No ABP ($71 / $30)Business Entertainment - No ABP ($92 / $55)Business Xtra - No ABP ($125 / $71)Business Optimo Mas - No ABP ($85 / $30)Inform Customer That First Months Sales is HigherPublic Viewing 1 Yr No ABPBusiness Select - No ABP ($79 / $45)Business Entertainment - No ABP ($121 / $88)Business XTRA - No ABP ($183 / $99)Business Optimo Mas - No ABP ($113 / $68)Business Mas Ultra - No ABP ($136 / $90)Inform Customer That First Months Sales is HigherPrivate Viewing 2 Yr ABPBusiness Select - ABP ($77/ $40)Business Entertainment - ABP ($97/ $65)Business Xtra - ABP ($139/ $100) + (RSF)Business Optimo Mas - ABP ($92/ $60)Inform Customer That First Months Sales is HigherBusiness Viewing 2 Yr ABPBusiness Select - ABP ($77/ $40)Business Entertainment - ABP ($97/ $65)Business Xtra - ABP ($139/ $100)Business Optimo Mas - ABP ($92/ $60)Inform Customer That First Months Sales is HigherPublic Viewing 2 Yr ABPBusiness Select - ABP ($79 / $45)Business Entertainment - ABP ($121 / $81)Business Xtra - ABP ($183 / $106)Business Optimo Mas - ABP ($113 / $70)Business Optimo Mas Ultra - ABP ($136 / $93)Inform Customer That First Months Sales is HigherPrivate Viewing 2 Yr No ABPBusiness Select - No ABP ($71 / $47)Business Entertainment - No ABP ($92/ $72)Business Xtra - No ABP ($125 / $98)Business Optimo Mas - No ABP ($85 / $51)Inform Customer That First Months Sales is HigherBusiness Viewing 2 Yr No ABPBusiness Select - No ABP ($71 / $47)Business Entertainment - No ABP ($92/ $72)Business Xtra - No ABP ($125 / $98)Business Optimo Mas - No ABP ($85 / $51)Inform Customer That First Months Sales is HigherPublic Viewing 2 Yr No ABPBusiness Select - No ABP ($79 / $55)Business Entertainment - No ABP ($121 / $91)Business Xtra - No ABP ($183 / $116)Business Optimo Mas - No ABP ($113 / $80)Business Optimo Mas Ultra - No ABP ($136 / $103)Inform Customer That First Months Sales is HigherResidential Account #Access Key Card #Total $0.00 Additional Promotions Free 32in TV NFL Sunday Ticket (*Private/Business Entertainment and Xtra package only) Gift Cards ($100 New U-verse customers only) channelNotes {all_fields} Δ
