AccuLinq The Original 8.9¢ National Access Calling Card 4.9¢ (local access) (No Surcharge* - Billed in 6 Second Increments after the first 30) CORPORATE CREDIT REFERENCE SHEET (Required only if not providing Credit Card for Backup Guaranteed Payment)

Office Use Only Sales: 860 AUTH #:

Company Name:

Tax ID Number:

Company Address:

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State:

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Phone #( )

Fax #( )

Incorporated Name if Different from Above:

Number of Years in Business:

Our Legal Entity is:

[ ] Corporation [ ] Partnership [ ] Proprietorship [ ] Other (Explain)

Name(s) of Principal(s):

Title:

Home Address:

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BANK REFERENCE: Note: Individual Accounts Must Complete This Section Accurately For Application To Be Processed In A Timely Manner

Bank Name:

Account Number:

Bank Address:

City:

State:

Zip:

Contact Person:

Title:

TRADE REFERENCES:

Company Name:

Home Address:

City:

State:

Zip:

Phone # ( )

Account Number:

Company Name:

Home Address:

City:

State:

Zip:

Phone # ( )

Account Number:

I hereby authorized Linq Telecom, Inc. (LINQ) to conduct a routine credit check in connection with my application for service. LINQ may use any information obtainable through this credit application of any credit reporting agencies. I understand that such information will be held strictly confidential and will remain LINQ's property whether or not credit is extended.

Signature: (Authorized Officer Only)

Print Name:

Date:

To secure you Calling Card today - FAX your Application to 800-909-7994 If Busy Alt. Fax # 888-218-5602

OR Mail to: AccuLinq • 5224 Kaltenbrun Road • Fort Worth, Texas 76119

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