Biz Net Technologies Internet Service Change Form

Not all services are offered at all locations.

Change ONLY the fields that need updating. Please use the notes section for clarifications.

Internet Service

Effective change date (optional)

Phone service

I will need phone service (please provide details in notes)

Company name *

Contact name *

Contact phone number *

Extension

Contact email *

Company address

Company address 2

Company city

Company state

Company zip

Receive invoices by

USPS

Preferred payment method

Recurring credit card auto debit - QuickBooks sign-in required, supports free or existing accounts. (PCI compliant)

Manual payments - payment link in invoice emails.

Other (please provide details in notes)

Billing company name

Billing company address

Billing company address 2

Billing company city

Billing company state

Billing company zip

Billing contact name

Billing contact phone number *

Billing extension

Billing contact email