Magdalena Transfer of Service Form

Customer Name*

Red Bolt Account Number*

Current Service Address*

Phone*

Email Address*

example@example.com

New Service Address*

Date Previous Address Disconnected:*

(Please note: Service at new location is not guaranteed to happen the same day that previous address is disconnected.) Please RETURN your managed router and Wi-Fi Extender (if applicable) until service is installed at the new service address, unless instructed otherwise by a Red Bolt customer service representative.

If you are changing your service plan or add equipment/additional service(s), please choose from below: (Prices do not include tax.)

Essentials Plan (100 Mbps) – $64.95Family Plan (300 Mbps) – $74.95Gamer Plan (600 Mbps) – $84.95Giga Plan (1,000 Mbps) – $94.95Managed Wireless Router – $7.00/month5Ghz WiFi Extender $3.95/monthPublic IP Address – $3.95/month

By signing this form, I understand I am still responsible for any unpaid bill or past due amounts owed from the previous service address. My first bill after transferring service will be pro-rated from the date of connection until the end of that month.

By changing my service plan and/or adding equipment/additional services, I understand that the changes and charges as shown, plus tax, will be reflected in the next billing cycle.

By signing this form, I understand that a $20 cleaning fee plus tax, per device, will be assessed if the equipment needs cleaning. If the equipment is returned unusable (e.g. returned without power cord or damaged) I am responsible for full retail value of the equipment.

Signature*

Date*

Date

1821 Clif Lear Ave. / PO Box 1087 / Grants, New Mexico 87020 / redboltbroadband.com / Ph: 505.876.2005 / Fx: 505.287.2234