Device Order Form

Company Name*

Submitter Name*

First Last

Submitter Email*

Employee/User of new device*

(Click the + button to add multiple)

Order Type*

New line of service with new phone number
Porting in existing number from another carrier
Upgrade
Assumption of liability – Moving personal line to the business for the same carrier (ie. moving AT&T personal line to AT&T business account).

Phone ordering*

Carrier Requested*

Verizon
AT&T

IMEI of Existing phone requiring activation

ICCID# (Sim card number)

For AT&T devices, must be a new AT&T sim card. If you do not have one, we will ship one out so you may leave this blank.

Service address for new employee (needed to obtain the correct area code)*

Street Address Address Line 2 City State ZIP Code

If you do not have the employee’s address, put in the corporate address and we will assign an area code to that location.

Number of Devices

Porting in existing phone number for employee

Cell number porting in*

Porting a number from another carrier to your carrier on your corporate account. If the carriers are the same, select the transferring line option instead.

Carrier porting from*

Verizon
AT&T

Porting Account number*

Name on account (Personal or Business name)*

Password or pin# (the one you use when calling in to your carrier, not the one used to login online)*

Porting Billing address (if available)

Street Address Address Line 2 City State ZIP Code

This field is hidden when viewing the form

Upgrade

Cell# upgrading*

Buddy line# for upgrade eligibility

We will choose the line if not specified

Carrier*

Verizon
AT&T

This field is hidden when viewing the form

Transferring a line in to the company from another personal or business account

Business or Personal Name on account releasing the line*

Personal/business phone number transferring in*

Has the line been released from the person or business*

The line been released from the person or business

Has the installment balance been paid off?*

the installment balance been paid off

Carrier Requested*

Verizon
AT&T

Carrier we are porting to or ordering a new line of service on.

This field is hidden when viewing the form

Generic Info

Device model requested*

Color & GB Size

If not filled in, we will do base GB and Black

Shipping Address for phone or sim card (if different than the service address or corporate location)

Street Address Address Line 2 City State ZIP Code

Attention*

Shipping*

Priority overnight $14.99
2 Day Free Ship

Additional notes or special instructions

Company Helpdesk Ticket#

Mobile Device Order Form

Porting in existing phone number for employee

Upgrade

Transferring a line in to the company from another personal or business account

Generic Info