NEMR Customer CPNI Form Under federal law, you have the right to confidentiality of information regarding your telephone services and Northeast Missouri Rural Telephone Company has the duty to protect that confidentiality. This confidential information includes such things as specific services you purchase, the number of services purchases, who your provider is for a service, long distance call detail records, and charges related to the services purchased. This information is referred to as Customer Proprietary Network Information (CPNI).Among the new rules is the option for you to establish a PASSWORD with Northeast Missouri Rural Telephone Company and provide that password during a telephone call from you before we are authorized to disclose or discuss call detail records. For your protection, this password cannot derive from readily available biographical information such as your social security number, mother's maiden name, home address or date of birth.If your account is listed only in your name, you probably should consider assigning one or more "Authorized Account Representatives" - for example, husband, wife, child, parent, roommate, etc. The Authorized Account Representative/s will not be added to your account, but they will be added to our records as being a person/s that you have authorized to make changes to your services or to discuss billing or service information regarding your account. For our married residential subscribers, we suggest for your convenience that both husband and wife be listed as "Authorized Account Representatives".If you choose not to establish a password, there are alternatives that can be used in order for us to discuss or provide you call detail information. These methods may prove to be inconvenient for those who call about their account from work, from cell phones, or from any place away from the telephone number of record.*Northeast Missouri Rural Telephone Company can send the call detail information to the address of record.*We can call you back at the telephone number of record from which your service is derived.*We may disclose call detail CPNI to you at our business office with a valid photo ID matching the name listed on the account.*We may discuss only the call detail information you provide such as called number, when it was called, the duration of the call, and, if applicable the amount charged for the call.What City Were You Born In?(Required) PhonePhonePhonePhonePhonePhoneLIST ALL PERSONS YOU AUTHORIZE TO MAKE CHANGES OR DISCUSS INFORMATION REGARDING YOUR ACCOUNT:Note: These are the ONLY persons that we will talk to about your account. For example, you might want to list your spouse, girlfriend/boyfriend, son, daughter, roommate, mother, father, etc.Authorized User #1(Required) Relationship(Required) Contact Number(Required) Authorized User #2 Relationship Contact Number Authorized User #3 Relationship Contact Number Authorized User #4 Relationship Contact Number OPT-OUT: Unless you check the "Opt-Out" box below, it will be assumed that Northeast Missouri Rural Telephone Company has your approval to offer you products and services that you may find to be valuable additions to your existing services. I would like to OPT-OUT Use E-mail for Contact(Required) May we use your email listed above to contact you? - If you would rather us use an alternate email, select "No".(Required) Yes No Name(Required) First Last Date(Required) MM slash DD slash YYYY Signature(Required)
