Biz Net Technologies Internet Service Change Form

*Not all services are offered at all locations

**Change ONLY 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 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 state

Billing company zip

Billing contact name

Billing contact phone number

Billing extension

Billing contact email