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General Info
Carrier Legal Name
*
Address
*
(ex: ABC Telecom, Inc.)
 
Address2   
Carrier Account Name
*
City
*
(ex: ABC - Conversational)
 
State
*
 
 
Zip
*
Username
*
 
 
Password
*
 
 
Re-type Password
*
Contact Info
Business Contact
Name
*
Phone
*
Mobile   
Email
*
Skype   
Technical Contact
Name
*
Phone
*
Mobile   
Email
*
Skype   
TROUBLE TICKET EMAIL
*
Billing Contact
Name
*
Phone
*
Mobile   
Email
*
Skype   
BILLING DISPUTE EMAIL
*
Other Contact
Name
Phone
Mobile
Email
Skype
Technical Info
LRN
Yes
No
 
 
Overall Session Limit
 
 
Overall CPS Limit
Add
Destination IP:
Destination Prefix:
Destination Port:
Session Limit Per IP:
CPS Limit Per IP:
Enabled:
Yes
No
Confirm and Finish
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Must have a lowercase and cap
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Must have a number
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Passwords Match