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CLEC Master Account Questionnaire Form

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Wholesale
Forms
CLEC Master Account Questionnaire Form

CLEC Master Account Questionnaire Form (CMAQ)

Form Submission Date

Form Submission Type:

Form Submission Type Initial Change (Provide change description below)

Please type the change details here

*Denotes Required Field

Requestor Information

Name*

Phone Number*

Email Address*

Wholesale Customer Information

Wholesale Customers must submit a separate CLEC Master Account Questionnaire for each CCNA.

Company Legal Name*

Doing Business As (DBA) [List All]

Street Address*

City*

State*

Zip*

CCNA*

Phone Number*

Product Options

Check all that apply:

Product Options LIst LNP only (no directory listings) [CB] LNP w/ Directory Listings [CB] Stand Alone Directory Listing Only (no LNP) [JB] Loop (ACTL required below) [AB, BB] Resale [EB, KB, LB, NB, PB, QB] Wholesale Advantage Voice [DB]

Note: if ordering under Resale BAN, established Resale Agreement required.

Federal Tax ID Number*

State Specific Information

Check the States where you will order Frontier services.

State AL AZ CA CT FL GA IA IL IN MI MN MS NC NE NM NV NY OH PA SC TN TX UT WI WV

Complete section for each state where your company will be doing business with Frontier.

1. OCN and State Tax ID Number are required for all product options. (Note: voice CLECs must provide UNE-P state specific OCNs)

2. SPID is required for LNP product options.

3. ACTL is required for Loop product option.

AL - Alabama

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

AZ - Arizona

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

CA - California

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

CT - Connecticut

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

FL - Florida

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

GA - Georgia

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

IA - Iowa

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

IL - Illinois

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

IN - Indiana

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

MI - Michigan

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

MN - Minnesota

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

MS - Mississippi

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

NC - North Carolina

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

NE - Nebraska

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

NM - New Mexico

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

NV - Nevada

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

NY - New York

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

OH - Ohio

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

PA - Pennsylvania

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

SC - South Carolina

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

TN - Tennessee

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

TX - Texas

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

UT - Utah

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

WI - Wisconsin

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

WV - West Virginia

OCN*

State Tax ID Number*

SPID*

ACTL from Collocation Agreement*

Street Address Guide (SAG)/911 Contact Information

Contact to address 911 Address Discrepancies:

Name

Email Address

Phone Number

Cell Number

Ordering Contact Information

Contact to address service order issues:

Name*

Email Address*

Phone Number*

Cell Number

Provisioning Contact Information

Contact to address service provisioning issues:

Name*

Email Address*

Phone Number*

Cell Number

Escalation Contact Information

Contact to address provisioning/ordering escalations:

Name*

Email Address*

Phone Number*

Cell Number

Maintenance/Repair Contact Information

Contact to address maintenance issues:

Name

Email Address

Phone Number

Cell Number

If your end-users call Frontier’s Repair Call Center in error, what number(s) should they be directed to call:

Regular Business Hours

Time Zone EST CST MST PST

Phone Number During Regular Business Hours:

Emergency Repair Number (if different):

Billing Information

Billing Remittance

Provide the mailing address where your Frontier billing statements should be sent.

Company Legal Name*

Department/ATTN:

Street Address*

City*

State*

Zip*

Billing Contact Information

Contact to address bill processing, adjustments, and payments:

Name*

Email Address*

Phone Number*

Cell Number

Bill Media Options*

Bill Media Options BDT Paper Bill

If 'Paper Bill' not checked, paper bill will be suppressed

Selecting BDT as a Bill Media Option requires a Billing Feed Connectivity Form submission.

Please access form at: https://wholesale.frontier.com/Forms/Billing-Feed-Connectivity-Form.

Method of Payments to Frontier*

Method of Payments to Frontier Check Electronic Funds Transfer

Please visit https://wholesale.frontier.com/billing/payment-remittance for payment information.

Tax Exemption Contact Information

Name*

Email Address*

Phone Number*

Cell Number

If the new wholesale billing account numbers are to be coded “exempt” from any applicable taxes and surcharges, certificate of exemption from the Federal Excise Tax and all other appropriate forms indicating exemption from state/local taxes must be provided.

All Tax Exemption Forms and any additional tax exemption information must be submitted via email to: wholesale.tax.exemption@ftr.com.

Issues related to completing the CLEC Master Account Questionnaire Form (CMAQ) should be directed to Frontier.Connectivity.Management@ftr.com.

PROPRIETARY NOTICE
THE MATERIAL CONTAINED IN THIS WEBSITE AND THE AVAILABLE REFERENCE DOCUMENTS INCLUDING ANY TRANSLATIONS, COMPILATIONS, WHOLE OR PARTIAL COPIES, TOGETHER WITH ANY SUBSEQUENT REVISIONS OR ADDITIONS ARE AND SHALL REMAIN THE PROPERTY OF FRONTIER COMMUNICATIONS PARENT, INC. AND ITS AFFILIATES. NO PORTION OF THESE MATERIALS MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM BY ANY MEANS, ELECTRONIC, MECHANICAL OR OTHERWISE, INCLUDING PHOTOCOPY, RECORDING OR ANY INFORMATION STORAGE OR RETRIEVAL SYSTEM WITHOUT ADVANCE WRITTEN PERMISSION FROM FRONTIER. SHOULD THE HOLDER OF THESE MATERIALS HAVE SUCH WRITTEN PERMISSION TO MAKE COPIES OF THESE MATERIALS, ALL SUCH COPIES MUST CONTAIN THIS PROPRIETARY NOTICE. FRONTIER IS A BRAND NAME USED BY THE FRONTIER, CITIZENS AND OTHER AFFILIATED LOCAL EXCHANGE COMPANIES. ALL RIGHTS RESERVED.

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