Residential Address & Phone Numbers of Principal Owner or Partners
Local Telephone Service
Installation is $67.00 per line plus 1st month local service $34.00 in advance (Total $101.00)
Basic Residential service in 349 calling area is approximately $34.00/month
Extended Community Calling (ECC) is billed at $.05/minute
Notification upon application for service:
The Public service Commission of Wisconsin’s Administration code Chapter 165.052(5), states:
“A utility shall not disconnect any RESIDENTIAL service without notifying the County Department of Health and Social
Services at least 5 calendar days prior to the scheduled disconnection IF THE CUSTOMER OR A RESPONSIBLE
PERSON HAS MADE A WRITTEN REQUEST FOR THIS PROCEDURE TO THE UTILITY.” We are required to
inform you of this right.
In making this application the undersigned agrees to the rules and regulations of Siren Telephone Company, Inc.
Set forth in the Telecom tariff, and to any general changes in rules, or rates for the service furnished under this
application. This application becomes a contract when accepted in writing by Siren Telephone Company, Inc.
If applicant/s credit rating is found to be not satisfactory a cash deposit will be required.
I certify that all the information provided is correct to the best of my knowledge and that any false statement provided is
grounds for Siren Telephone to discontinue telephone service.