Application for Services

All fields with asterisks (*) are required.

Billing Information (Applicant must be 18 years old)

Employer Information

Have you ever had service with us before?

Co-Applicant Information

If you will have a co-applicant, please enter their information.

You have the right to restrict the use of your CPNI (Billing Information).

Do you approve of the use of your CPNI?
Choose Calling Features:
*If you do not block 900 calls, you will be responsible for any and all 900 call charged to your account. (They are $5.00 per minute)

**Billing date is 1st of the month. Bill must be paid before the 14th to avoid disconnect notice.

Regulatory and Services Fees

  • R-1 $18.00

  • FCC Access Line $6.50

  • 911 Charge - $0.50

  • Service Order Charge - $15.00

  • Line Connection Charge - $15.00

  • Inside Wiring Charge - $45.00

Bundle Options
Select Internet Options
Select SkitterTV Options**

Customer Agreement:

I agree that I will be obligated to the cable TV service for a period of one (1) year to qualify for this introductory offer.

I agree to pay a monthly fee according to the plan selection on this application. I agree to pay the monthly bill by the 14th of each month if billed on my telephone bill/cable bill. I understand that my cable services will be disconnected on the 10th day past the due date if I have not paid. I will be charged an additional 5% on any late payments after the due date. If my cable services are disconnected for non-pay, I will be responsible for all past due balances and a $25.00 plus tax reconnect fee before services will be reconnected.

I understand that my monthly charges include the rental fee for equipment required for services: set top boxes, remote controls and modems. I understand  the full terms of service for SkitterTV offered by Lake Livingston Telephone Company are available for them Lake Livingston Telephone Company's website (www.lakelivingstontel.com) and it is my responsibility to review these terms or to request a printed copy if I do not have internet access.

I also understand that I am fully responsible for any set top box, modem and hand-held remote controls that I am provided with during service with LLTC/LLCI. All equipment remains the property of LLTC/LLCI. If the equipment is destroyed, misused, abused or stolen then I, the customer, will be responsible for reimbursement of said equipment.

I also understand that in the event my account is closed wither by my request or for non payment, I will be responsible for returning all equipment or criminal charges will be pressed against me for theft of equipment.

Internet Services

LLTC will waive the installation and programming charges for any new subscriber to the DSL services, with a one year contract. The customer will be obligated to the DSL service for a period of one year to qualify for this introductory offer. If customer fails to complete the full 12-month agreement, customer is responsible for the installation charges after the initial 30 days. In addition, the installation charge of $100.00 will be billed on a prorated amount when at the time, the termination of services occurs. (Either customer or LLTC initiated). All remaining charges for DSL service from the installation date are due in full at the time that service is terminated. All equipment placed into service at customer's premise (modem and accessories) is the property of LLTC and is required to be returned to LLTC at the termination of service. If any LLTC provided equipment is not promptly returned, customer will be billed for said equipment.

I agree to pay a monthly fee according to my plan choice. I also understand that if I connect online and there is no activity, (such as walking away leaving the computer online but setting idle) for 30 minutes, my connection may be dropped until the next time I set the computer to reconnect. I understand I may experience some delays on the Internet. I also agree to pay the monthly by the 14th of the month, with the understanding that I will be disconnected on the 28th of the month if, I have not paid the bill. I will also be charged an additional 5% on any late payments.

Customer Signature