AT&T Telephone Calling Card Request Form
Date: The date you are completing the request.
Coordinator: Telecommunications Coordinator with an authorization form on file.
Agency: The complete name of your agency.
Street: Street address and building location of employee (coordinator filling out the request) requesting the calling card.
City: Office location of requesting Telecommunications Coordinator.
Phone Number: Please include the Telecommunications Coordinator’s phone number here.
Note: In the grey area on the request form, you are asked to choose one of the following:
In the grey area on the request form, you are asked to choose one of the following:
Issue new card: Check this box if you are requesting a new card for someone who does not currently hold a calling card/does not currently have a calling card account. This is not to be used when asking for a replacement card for an existing account. CMS will add the remaining information during order processing. If International calling is required, check the Add International Calling box.
Delete card: This box is checked to terminate an existing credit card. Name and AU should be filled in; card number is the critical information for this request. Instruct the user to destroy the old card or require the user to return the card to the Telecommunications Coordinator.
Change: Check this box for changes to AU, Name, or to Add/delete International Calling. This is for changes only. The existing card will not be changed or replaced. Card number, name and AU is necessary for this request. For AU changes, place the existing and new Aus in their appropriate places. For name changes, place the current account name in the Name field and note the change(s) to be made beside the checked box change existing name. For International calling to be added or deleted, check the correct box.
Re-issue card: This box is to be checked for either or both reasons. First, this type of request is used to make a change to the card itself or a name change when the user wants a new name to appear on the card. This type of request is also used to replace old and damaged cards. Requirements are similar to those for “change” above. Card number, name and AU must be included. Write in the desired name changes or “replace card” beside the checked box. This request requires the agency to destroy the old card.
The following information regards the requesting employee and associated billing account:
Name: Please print the name of the employee who will hold the calling card. Provide last name followed by first name.
AU# : The accounting unit (au) code is provided by the agency and must be established prior to completing the request form.
Change AU # to: If you have an existing account and merely want to change the accounting unit or au under which this account is billed.
Coordinator’s signature: The request form must be signed by the very same person (approved Telecommunications Coordinator) whose name is printed in the top portion of the form. This person must have an Authorization Form on file with CMS in order to process the calling card request (as well as any other order for Telecommunications service).
Submit Calling Card Request to:
Customer Service Center
120 W. Jefferson St., 2nd floor
Springfield, IL 62702-5103
Customer Service Center
[in Springfield at 217-524-4784]