switchandsave@cellcom.com Switch and Save Business Request Form Name on Account: Cellcom Account Number
Switch and Save Business Request Form Name on Account: _________________________________________Cellcom Account Number:____________________ Street Address: ____________________________________________City/State/Zip______________________________ Wireless Phone Number Fee(s) __________________________ $_____ __________________________ $_____ __________________________ $_____ __________________________ $_____ __________________________ $_____ __________________________ $_____ Note--if additional lines of service requests needed, please add to back of form Wireless Phone Number __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ Fee(s) $_____ $_____ $_____ $_____ $_____ $_____ Total Reimbursement Request*$__________ *Maximum of $5,000 per account per 18-month period I certify by my signature that the information I have entered on this certificate is complete and correct. I agree to the terms and conditions noted below. ________________________________________________________________ _____ /_____ /_____ Signature Date To receive your contract payout/reimbursement credit(s): 1. Complete, sign and date this original reimbursement request form. Incomplete forms or documentation will not be processed. 2. Include a copy of your Cellcom store receipt with store name circled. 3. Provide a copy of your entire final competitor wireless bill with early termination fee charge or final equipment installment payment circled for each line. Please note that taxes and other fees charged on termination fees are excluded and will not be reimbursed. 4. Verify the name and address on your Cellcom account matches the name and address on the competitor's bill. (Printouts of online accounts, store receipts or credit card receipts will not be accepted as proof of early termination fee payment.) 5. Please keep a copy of the form, receipt and wireless bill for your reference. Email to switchandsave@cellcom.com OR mail to the following address within 60 days of activation: Cellcom Contract Payout P.O. Box 12466 Green Bay, WI 54307-13061 Terms and Conditions: Activation at time of service with Flex or 2-Year Agreement and credit approval required on smartphone or basic phone. Tablets, Mobile Broadband, Connected Devices etc. are not covered. Advance Pay services are not eligible for this offer. Payout Offer available to new Cellcom Business lines on new or existing accounts, up to $5,000.00 per account, per 18-month period. Must port in number to Cellcom. Accounts requiring a credit deposit are not eligible. Account must have been deactivated for greater than 60 days. Phone must remain active on the line of service for 15 months. If the customer cancels a ported line, the ETF credit issued to that line will be charged back to their account. Account must be in good standing without any outstanding past-due balances to receive credits. Not redeemable for cash. To apply for credits, you must submit a copy of your original dated Cellcom store receipt, a completed reimbursement form along with the entire copy of your last wireless bill from your previous wireless carrier that includes the charge for the early termination fee on each line. Cellcom has the right to request a copy of your original service agreement. Interofficed copies, or facsimiles will not be accepted. All reimbursement forms must be postmarked/emailed within 60 days of activation. Reimbursement forms that are counterfeited, mechanically reproduced, altered or tampered with are void. Cellcom is not responsible for inaccurate, incomplete, illegible, lost, damaged, postage due, misdirected or late reimbursement forms or for any services provided by third parties. All materials received become the property of Cellcom and cannot be returned. Credit is non-transferable. Cellcom does not cover Lease Device Purchase Amounts. Please allow six-eight weeks after receipt of reimbursement form for application of credit(s) on your Cellcom bill(s). This offer is for end-users only; dealers or carriers are ineligible. Cellcom cannot apply your credit unless you accurately and legibly complete all above information fields on the reimbursement form. Offer open to legal residents of the United States only. Void where prohibited or otherwise restricted by law. One request per postmarked envelope. Call 800-2360055 with questions. Fraudulent submissions could result in prosecution under U.S. Mail Fraud Statute (18 USC Section 1341-1342). Promotion offer subject to change at any time. See Rep for details.Adobe PDF Library 20.6.74