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Service Disconnection/Removal

    Note:
    • Impact of Federal and State Asbestos Regulations: (more...)
    • Departmental Billing (more...)
    • If you are requesting disconnection of an existing 2-ledger coded telephone service you may want to consider keeping the phone for future use. Removal of a service will not change your department’s permanent budget reallocation, based upon the 2010 new funding model. 

*Required

Department and Billing Information

Department Name: *
Department Number  
UConn Campus:  
Department Head's Name:  
Has the department head
authorized this request?		 * Yes
No		 Approval is required.  By indicating "yes", your department agrees to pay for all charges that pertain to this request.

Contact Information

Contact's Name: *
Contact's Telephone #: *
Contact's E-mail: *

Subscriber Information

Subscriber's Name:
Name on the phone bill:		  First: Last:
Subscriber's E-Mail:

Telephone to be Disconnected

Telephone Number: *
Building Name *
Room Number *
Jack Number * ** If a New Jack is required please type in NEW, for locations with existing jacks the Jack Number is required.

What is to be Disconnected?

SINGLE LINE SET Desk
Wall
Speakerphone
MULTILINE SET 10 Button
24 Button
LINE ONLY: (No phone set) Modem
Fax
Secondary
Call Forward Remote
Other: (Please Specify)

Comments:




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Updated: 7/12/2010