Masterline Messaging Order by Fax Form Pay Per Month -- Monthly Billing Plan Important: Read the User Agreement before ordering. Print this Page and Fax to 619.582.4616

Quantity Description Price Total (1) Service Level Selection: Monthly Base Fee (MBF) and Activation Fee prepaid by credit card. You will be charged the MBF plus any applicable usage fees thereafter on a monthly basis. All fees are non-prorated and non-refundable. Upon cancellation of service, a one-time disconnect fee of $50.00 applies. Deposits will be applied to final balance upon termination. Disconnect fee is separate from any outstanding balances. For special priced promotions enter promotion code on your company fax form. ________ OneConnect - Office Assistant $49.95 x 2 MBF ________ ________ OneConnect - Personal Assistant $39.95 x 2 MBF ________ ________ Executive Greeting service $CALL FOR QUOTE$ ________ ________ Personal800 $49.95 x 2 MBF ________ ________ Custom Greeting Service $39.95 x 2 MBF ________ ________ Custom Numeric with Voice Mail $24.95 x 2 MBF ________ ________ Custom Numeric $19.95 x 2 MBF ________ ________ Masterline Message Center $19.95 x 2 MBF ________ (2) Service Activation Fee: ________ Per User (non-refundable) $50.00 ________ ________ Deposit (non-refundable) $150.00 ________ Sub-total: ________ ________ Consultation Fee(s) $140.00 hourly rate or portion thereof ( First hour free) Total: ________

**** ORDERING INFORMATION ****
Billing and Company account information: No P.O. Boxes please
Fill-in all blanks. Please print clearly. All orders are subject to credit check.
Company Name:________________________________________________Order Date: ______________
Federal Tax ID:____________________________: or Social Security#:___________ ___________________
Dun & Bradstreet#:_________________________________________________________________
Company Address:_________________________________________________________________
City/St/Zip:______________________________________________________________________
Billing Address:_________________________________________________________________
City/St/Zip:______________________________________________________________________
Contact Name:_________________________________________________________________
Contact Phone#:_________________________________________________________________
Contact Email:_________________________________________________________________
Company Phone#:________________________________________________________________________
Company Fax#:__________________________________________________________________________
Company Email:__________________________________________________________________________ (Company email addresses only. We do not accept Yahoo, MSN, or other personal email addresses.)
Linking Information: Per User -- No text addresses please
User Name:_____________________________________
Linking Device Type (i.e. Cell, Blackberry, Pager, etc):_____________________________________
Carrier Name (i.e. Cingular, Verizon, etc):_______________________________________________
Device Number or PIN number:________________________________________________________
Delivery Address/Email Only:_______________________________________________________
. Authorized Signature:________________________________________________ Date: _____________ Tel/Email (if different from above)_____________________________________________________
By activating the Service: (i) You acknowledge that you have read and understood, and you agree to the terms and conditions of this Agreement; (ii) You represent that you are of legal age to enter this Agreement and become bound by its terms; (iii) You are authorized by your company to enter into the agreement. Important: Read the User Agreement before ordering.

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