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PA001 Form
PA001 Administration Request Form
Switch Information
Complete one group of fields for each PBX. If you have more than 5 PBXs, pho
this page before you begin.
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________
Dial String: ________________________________
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________
Dial String: ________________________________
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________
Dial String: ________________________________
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________
Dial String: ________________________________
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________
Dial String:
G
Data Module (9
G
Analog (1200)
G
Data Module (9
G
Analog (1200)
G
Data Module (9
G
Analog (1200)
G
Data Module (9
G
Analog (1200)
G
Data Module (9
G
Analog (1200)
Issue 2 April 1996
A-7
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