Ariel to Cougar Fiber-to-the-Home (FTTH) ISP Transfer Affidavit

Affidavit for ISP customers to fill out if they would like to switch ISP providers.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone(Required)

Date of Service Transfer Appointment:(Required)

Prior ISP Service Provider:(Required)

RFN

Other

New ISP Service Provider:(Required)

RFN

Other

Consent/Authorization(Required)

I, the undersigned, authorize the New ISP Service Provider listed above to act on my behalf to initiate the transfer of broadband service from my current Internet Service Provider using the Port of Woodland’s FTTH network. I understand this authorization allows the transfer of my service and associated connection at the service address listed above. I also understand: -My existing service with the Prior ISP Service Provider may be subject to contractual terms or early termination fees. -The Prior ISP Service Provider may contact me to verify this transfer request. -My approval below authorizes Port of Woodland and/or its network operator to facilitate the change in provider as instructed.

Signature(Required)

Name(Required)

First Last

Date(Required)

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Ariel to Cougar Fiber-to-the-Home (FTTH) ISP Transfer Affidavit

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