REQUEST TO ADD AN “AUTHORIZED” PERSON TO YOUR ACCOUNT; ADD OR CHANGE YOUR ACCOUNT PASSWORD; ADD OR CHANGE YOUR SHARED SECRET AND ANSWER

PLEASE READ CAREFULLY

We, at Pine Belt Telephone Company, Inc., Pine Belt Cellular, Inc. d/b/a Pine Belt Wireless, Pine Belt Communications, Inc. d/b/a Pine Belt Long Distance and Pine Belt Broadcasting, LLC d/b/a Pine Belt Telephone Competitive Services (collectively, “Pine Belt”), have always guarded our subscribers’ private information with complete confidentiality and will continue to do so. Due to a change of FCC (Federal Communications Commission) rules based on an increase of attempts made by third parties nationwide to gain access to customers’ private information, Pine Belt is making the following changes to further protect your account information.

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If you would like your spouse, or other authorized person to be able to contact our office to discuss your telephone bill, including your call record detail, you will need to add that person to your account as an “authorized person”. The person that you add to your account will have the same privileges that you do in accessing your account information (including call record detail).

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If you wish to add your spouse or other authorized person to your account, or if you wish to add or change your account password, or if you would like to add or change your shared secret and answer associated with your account please complete this form and return it to our business office. You may return this form below by mail to Pine Belt, P. O. Box 279, Arlington, AL 36722, you may fax the form to 334-385-2103, or you may return the form to us in person to any of our business office locations. Verbal requests will not be accepted.