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Issue 2 April 1996 A-7
PA001 Form
PA001 Administration Request Form
Switch Information
Complete one group of fields for each PBX. If you have more than 5 PBXs, pho
this page before you begin.
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________ Data Module (9
Dial String: ________________________________ Analog (1200)
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________ Data Module (9
Dial String: ________________________________ Analog (1200)
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________ Data Module (9
Dial String: ________________________________ Analog (1200)
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________ Data Module (9
Dial String: ________________________________ Analog (1200)
PBX # _______
Switch Name: ______________________________ LDN: (_____) _____-__
Switch Release: ____________________________ Alarm ID: ___________
Customer Name: ____________________________ Modem Type:
Customer Location: _________________________ Data Module (9
Dial String: Analog (1200)