Updated 10/21/2008

Indirect Channel 3rd Party Plan Request Form

This form should be used for new Executive or 3rd party Sales Maker lines of service. IAE should send approved and completed form demorequests@sprint.com. All fields are required (unless notated).

Employer's Information
Dealer/Retailer Name Location Address Location Phone # Dealer/Retailer Contract ID Location Agent Code

Sprint IAE (Authorized Approver) Information

Name Phone # Email Marni Pinks 701-306-3484 Marni.Pinks@sprint.com

Employee Billing Information

Employee Name Employee Billing Address City, State, Zip Contact Phone # Driver's License Number Expiration date of license State license issued in Social Security Number Date of birth

Current Account (Sprint/Nextel) Information (if applicable)

Account Number Account Name Existing PTN

Port-In Information (if applicable)

Wireless Carrier (AT&T/Verizon/T-Mobile, etc.) Existing Account Number Existing PTN

New Account Security Information

In order for the account to be billed appropriately all the following MUST be completed. Rate Plan ($0 Executive or $20 Sales Maker) Handset make and model Handset ESN/SIM Handset IMEI (IDEN Only) Handset MSN (IDEN Required) Desired Area Code & Prefix (NPA-NXX)//Port In Add-On, Please list all (BlackBerry, TEP, etc.) Pin Code: Must be 6 numerical digits. Security Question: Check One, place answer in box.
First Elementary School First Employer Childhoold Best Friend's Name

New

Add-on

20.00 salesmaker

Make or Model of Your First Car First Pet's Name

Favorite Hobby

Childhoold Best Friend's Name Street You Grew Up On

Favorite Hobby

Employee Signature:

To take advantage of the 3rd Party Employee Program Sprint requires a signed 2-year Advantage Agreement. Not agreeing to this term will make you ineligible for this program. The Sprint Advantage Agreement ("Agreement") is your Agreement for Sprint Service and includes the term of your service pla and the most recent Sprint Terms and Conditions of Service ("Ts and Cs") - carefully read these terms which include, among other things, a MANDATORY ARBITRATION of disputes provision. A copy of the Ts and Cs comes with your phone, and is also available at Sprint Stores, www.sprintpcs.com, or through Customer Service Solutions department.Term Agreements: Your Agreement requires you to keep a phone active/maintain a line of service for a minimum Term, the Term begins on the phone activation date; for customers changing service plans, the Term begins when the new service plan is selected. You m terminate any line of service before its Term ends by calling *2. o Upon end of eligibility, employee will be contacted via text message informing them th they are no longer eligible for 3rd party employee program and will be moved to a consumer rate plan or they can contact 800-927-2199 to switch to a consumer rate plan of their choice. All lines that switch to a consumer rate plan will become liable for an Early Termination Fee should they cancel servi prior to the end of their contract.

el 3rd Party Plan Request Form

y Sales Maker lines of service. IAE should send approved and completed form to nt.com. All fields are required (unless notated).

Marni Pinks 701-306-3484 Marni.Pinks@sprint.com

applicable)

following MUST be completed.

20.00 salesmaker

Make or Model of Your First Car

quires a signed 2-year Advantage Agreement. Not agreeing to this term will make you greement") is your Agreement for Sprint Service and includes the term of your service plan and Cs") - carefully read these terms which include, among other things, a MANDATORY es with your phone, and is also available at Sprint Stores, www.sprintpcs.com, or through our Agreement requires you to keep a phone active/maintain a line of service for a minimum ers changing service plans, the Term begins when the new service plan is selected. You many o Upon end of eligibility, employee will be contacted via text message informing them that will be moved to a consumer rate plan or they can contact 800-927-2199 to switch to a sumer rate plan will become liable for an Early Termination Fee should they cancel service