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Order Capcodes Form 

Once you receive your capcode assignment, it is
your responsibility to load the equipment
to your BOSS reseller account.

BOSS Account Number: * (Up to 7 Numeric characters)
Account Name: *
Contact First Name: *
Contact Last Name: *
Contact E-Mail: *
Contact Fax Number: - - *
Quantity: *
Frequency: *
Service Type: *
Baud Rate: 512 1200  2400 FLEX REFLEX *
Comments:
Submitter Notes:
  bullet All required fields must have valid entries or your order will not be processed.
  bullet If you have any questions, please contact Reseller Support at 800-742-2355.

CAPCODES THAT HAVE NOT BEEN PLACED INTO SERVICE OR RESERVE
WITHIN 365 DAYS OF ISSUING WILL BE AUTOMATICALLY RECLAIMED.

Fields with * are required.