Enter Order Here KR Communications Sales Form Step 1 of 2 50% Sales Representative* First Last Company NameCompany NameSales Representative Territory*TerritorySales Representative Email* example@example.comSales Representative Phone Number*(###) ###-####Type of Sale* Residential Sale Commercial Sale Customer Name* First Last Customer Phone Number*(###) ###-####Alternate Phone Number(###) ###-####Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Customer Email* example@example.comCustomer Credit Card/Debt Card Number*Customer Credit Card/Debt Card Expiration Date*XX-XXCustomer Credit Card/Debt Card CVC*Attach Additional Documentation (if needed) Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, gif, tiff, Max. file size: 15 MB. Service* DIRECTV AT&T Mobility Viasat Frontier Windstream CenturyLink AT&T Broadband ADT Social Security Number*Date of Birth* MM slash DD slash YYYY Date of BirthDIRECTV Package* Entertainment Choice Ultimate Premier How to Watch?* via Satellite via Internet EquipmentEquipmentEquipmentEquipmentEquipmentGenie,Mini,Mini,Mini,Mini ($50 Upfront Cost)Genie,Mini,Mini,Mini,HD Receiver ($99 Upfront Cost)EquipmentGenie,Mini,Mini,Mini,Mini,Mini ($100 Upfront Cost)Genie,Mini,Mini,Mini,Mini,HD Receiver ($198 Upfront Cost)Number of TV's*1 TV2 TV's3 TV's4 TV's5 TV's6 TV'sDriver License/ID Number*Driver License/ID State Issued*Driver License/ID Exp. Date* MM slash DD slash YYYY Data Package*AT&T Unlimited & More Premium PlanAT&T Unlimited Extra PlanAT&T Unlimited Starter PlanOtherData Package*NON UNLIMITED PACKAGEUpgrade Frequency*AT&T Installment Plan with Next UpAT&T Installment PlanNumber of Lines*123456789101st Device*Make - Model - GB Size - Color1st Device Porting Number?* Yes No 1st Device Porting Phone Number*1st Device BOYD (Bring Your Own Device)* Yes No 1st Device IMEI Number*2nd Device*Make - Model - GB Size - Color2nd Device Porting Number?* Yes No 2nd Device Porting Phone Number*2nd Device BOYD (Bring Your Own Device)* Yes No 2nd Device IMEI Number*3rd Device*Make - Model - GB Size - Color3rd Device Porting Number?* Yes No 3rd Device Porting Phone Number*3rd Device BOYD (Bring Your Own Device)* Yes No 3rd Device IMEI Number*4th Device*Make - Model - GB Size - Color4th Device Porting Number?* Yes No 4th Device Porting Phone Number*4th Device BOYD (Bring Your Own Device)* Yes No 4th Device IMEI Number*5th Device*Make - Model - GB Size - Color5th Device Porting Number?* Yes No 5th Device Porting Phone Number*5th Device BOYD (Bring Your Own Device)* Yes No 5th Device IMEI Number*6th Device*Make - Model - GB Size - Color6th Device Porting Number?* Yes No 6th Device Porting Phone Number*6th Device BOYD (Bring Your Own Device)* Yes No 6th Device IMEI Number*7th Device*Make - Model - GB Size - Color7th Device Porting Number?* Yes No 7th Device Porting Phone Number*7th Device BOYD (Bring Your Own Device)* Yes No 7th Device IMEI Number*8th Device*Make - Model - GB Size - Color8th Device Porting Number?* Yes No 8th Device Porting Phone Number*8th Device BOYD (Bring Your Own Device)* Yes No 8th Device IMEI Number*9th Device*Make - Model - GB Size - Color9th Device Porting Number?* Yes No 9th Device Porting Phone Number*9th Device BOYD (Bring Your Own Device)* Yes No 9th Device IMEI Number*10th Device*Make - Model - GB Size - Color10th Device Porting Number?* Yes No 10th Device Porting Phone Number*10th Device BOYD (Bring Your Own Device)* Yes No 10th Device IMEI Number*Previous Wireless Company Name*Previous Wireless Company Account Number*Previous Wireless Company Account Pin*Does Customer Have DIRECTV*YesNoDIRECTV Account Number*Viasat Zip Code Look up(Viasat) Data Package*Unlimited BronzeUnlimited SilverUnlimited GoldUnlimited PlatinumOther(Viasat) Unlisted Package*(Viasat) Internet Speeds (Mbps)*AT&T U-verse AvailabilityInternet Speeds (Mbps)*Business Name*Business Contact Name* First Last Business Contact Email* Business Phone Number*Business Service Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is Billing Address Same as Service Address?* Yes No Business Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Customer Credit Card/Debt Card Number*XXXX-XXXX-XXXX-XXXXCustomer Credit Card/Debt Card Expiration DateXX-XXCustomer Credit Card/Debt Card CVC*XXXAuto-Pay* Yes No Tax ID*Type Of Viewing* Public - any business that serves food and/or drinks (bars, restaurants, coffee shops) Business - businesses that do not serve food or drinks and have TVs accessible to their customers (gyms, salons, waiting areas, auto shops) Number of TVs*Estimated Viewing Occupancy*Please enter a number greater than or equal to 1.Public Viewing Package* Business Select Pack Commercial Entertainment Pack Commercial Xtra Pack Public Viewing Package* Business Select Pack Commercial Choice Pack Commercial Choice Plus Pack Business Viewing Package* Business Select Pack Business Enterainment Pack Business Xtra Pack Does the Building Have a Flat Roof?* No Yes (a non-penetrating roof mount will be required for installation- there is an upfront fee of $100 for this) Would They Like Any Sports Packages?* Yes No Fire Code Occupancy*Please enter a number greater than or equal to 1.**The customer will be required to submit an approved Fire Code Occupancy certificate to DIRECTV prior to the activation of any premium sports packageAttach Fire Code Occupancy Certificate*Accepted file types: iejpg, gif, png, pdf, Max. file size: 10 MB.ADT Packages* Traditional (Activation Fee $99) Traditional w/ Life Safety (Activation Fee $99) Remote (Activation Fee $99) Video Lite (Activation Fee $99) Control (Activation Fee $99) Video Lite & Control (Activation Fee $199) ADDITIONAL EQUIPMENTWindstream Internet Speed*Comcast/Xfinity Select All TV Internet Home Phone Comcast/Xfinity TV Packages*X1FlexComcast/Xfinity Internet Speed*Comcast/Xfinity Home Phone* New Number Porting Number Alder Packaging*Alder Essential (Plus $49 Activation Fee)Alder Secure With FREE Outdoor Camera (Plus $99 Activation Fee)Additional Equipment & Pricing Motion Detector ($2 additional monthly) Smoke Detector ($2 additional monthly) Glass Break Detector ($2 additional monthly) Door/Window Sensor ($1 additional monthly) Key Fob ($1 additional monthly) Medical Pendant ($1 additional monthly) Outdoor Camera ($4 additional monthly plus $50 on activation) Indoor Camera ($2 additional monthly plus $25 on activation) Frontier Internet Plans*Basic Interent & InterentFiberOpticInternet Fixed WirelessBasic Internet & Interent*Basic Internet 3MBasic Internet 6MBasic Internet 9MInterent 12MInterent 18MInterent 25MInterent 45MInterent 70MInterent 90MInterent 115MFiberOptic*FiberOptic 30/5mFiberOptic 50/50mFiberOptic 100/100mFiberOptic 200/200mFiberOptic 500/500mFiberOptic GIG ServiceInternet Fixed Wireless*Internet FW 12MInternet FW 18MInternet FW 25MInternet FW 45MDoes Your Customer Want Frontier TV* Yes No Frontier TV*Local TVPrime TVExtreme TVUltimate TVWhole Home DVR* Yes No Set-Top Boxes Needed*Notes/CommentsCAPTCHANameThis field is for validation purposes and should be left unchanged.