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Simply fill out the form below and return it to Carr Telephone Company.

Customer Name:______________________________________

Mailing Address:____________________________________

City:__________________	State:________	Zip:________

Telephone Number: (231)898-_____________
		  (231)898-_____________

Please check the appropriate choice for Carr Telephone Long Distance.
________Local (Intralata)- long distance calls within the 231 & 616 area codes.

________Long distance (Interlata)- all other area codes, both inside and outside of  the state.
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IF YOU CHOOSE CARR TELEPHONE AS YOUR LOCAL (INTRALATA) CARRIER YOU WILL 
AUTOMATICALLY HAVE CARR TELEPHONE FOR YOUR LONG DISTANCE (INTERLATA).
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Customer Signature:

____________________________________


Locally Owned & Operated

I authorize Carr Telephone to be my long distance carrier for the number(s) listed above.  You have chosen 
Carr Telephone.  This will designate Carr Telephone as your agent for carrier change.