Account InformationDate:* MM DD YYYY Account Name:*Person(s) responsible for this account. If husband and wife, please list both names. Primary Account HolderName:* First Last Social Security Number:*Date of Birth:* MM DD YYYY Contact Number:*Email Address:* Because TrioTel is a participant in a federal utilities financing program, we are required to identify and document as accurately as possible the ethnic classification on the eligible population in our service area. The information you provide will be used only for Federal Government reporting purposes. Please check one:*American Indian or Alaska NativeAsian or Pacific IslanderBlack or African AmericanHispanicWhiteOther Secondary Account HolderName: First Last Social Security Number:Date of Birth: MM DD YYYY Contact Number:Email Address: Because TrioTel is a participant in a federal utilities financing program, we are required to identify and document as accurately as possible the ethnic classification on the eligible population in our service area. The information you provide will be used only for Federal Government reporting purposes. Please check one:American Indian or Alaska NativeAsian or Pacific IslanderBlack or African AmericanHispanicWhiteOtherBilling Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Physical Address:* Same as billing address Separate physical address Separate Physical Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Choose One:*Office BuildingApartment BuildingOne Story (one level above ground)Two Story (two levels above ground)Finished Basement?*YesNoNo BasementRental Unit?*YesNoLandlord InfoLandlord's Name:* First Last Landlord's Contact Number:*End of Landlord InfoType of Service:*ResidentialBusinessAuthorized Persons:*TrioTel will only discuss account information with the person(s) authorized on the account. TrioTel will verify each person when coming into the office by asking to see a picture ID, or when calling, by asking for the last 4 digits of the account holders SSN (or if a business, the password on the account). Authorized individuals may receive information and make changes to the account.Password for Verification:*Application for Coop Membership:*I/We, the undersigned, a person(s), firm, association, limited liability company, partnership, corporation or body politic or subdivision thereof may become a member of TrioTel Communications, Inc. (hereinafter called the “Cooperative”) by complying with each of the following: Make this written application for membership and communication service; Agree to purchase from the Cooperative local telephone exchange service or broadband internet service and to pay promptly for such service(s) the Cooperatives established tariffs, rates and fees; Agree to comply with and be bound by the Articles of Incorporation and the bylaws of the Cooperative and any rules and regulations adopted by the Board of Directors; and Agree that no member may hold more than one membership interest in the Cooperative, and no membership shall be transferable except as noted in the bylaws.I agreeTV only customer - not eligible for Coop membershipCustomer Proprietary Network Information Notification:*The FCC has adopted rules to protect your privacy with regard to telecommunications information that is personal to you. This information is called Customer Proprietary Network Information (CPNI) and can be found in your calling and billing records. CPNI includes such things as the type and quantity of the services subscribed to, the equipment and facilities used, and the numbers, dates, times and duration of the calls you place. From time to time TrioTel may change its service offerings and make available new features or services that may enhance or improve the services to which you are already subscribed. Allowing us to use the CPNI in your account gives us the ability to give you more personalized service and offer you the products and services that best fit your needs. If you allow us to use your CPNI, it will be used only by TrioTel. TrioTel does not share customer information. You have a right under federal law to protect the confidentiality of your account information and we have a responsibility to protect your data. Your denial for TrioTel to use your CPNI will not affect the quality of your service or have any effect on the products and services to which you currently subscribe. Your decision on the use of CPNI by TrioTel will remain valid until you change it, which can be done at any time by calling our business office. I agree to let TrioTel use my CPNII do not agree to let TrioTel use my CPNI Collection Policy: BILLING: Statements will be mailed to the subscriber within the first week of the month. Monthly charges will be billed one month in advance. Failure to receive a bill does not relieve the subscriber of the responsibility for payment. Employees are not allowed to accept payments outside the business office. LATE PAYMENT: In the event that payment is not received in full by 12 noon on the 20th day of the same month in which service is rendered, a late charge of $2.00 minimum or 1 ½% of the outstanding balance will be assessed. A reminder notice will be mailed to the subscriber. NON-PAYMENT: If the delinquent account is not paid by 12 noon on the 10th day of the month following the month in which service was rendered, all services will be suspended. For subscribers with dial tone, 911 and 611 (business office) will remain active. When the 10th falls on a Friday or a day the business office is closed, service will be suspended on the following business day. RESTORAL: Any account that is suspended for non-payment will be assessed a $28.00 restoral fee. Service will be restored during regular business hours, after the account balance and restoral fee have been paid in full. NEW SUBSCRIBER: New subscribers will be required to sign the Prompt Payment Contract. Under the Prompt Payment Contract, payment is due in full by 12 noon on the 15th day of the same month in which service is rendered. Prompt Payment customers will not receive a reminder notice. In the event that payment is not received in full by 12 noon on the 15th day of the same month in which service is rendered, all services will be suspended. For subscribers with dial tone, 911 and 611 (business office) will remain active. When the 15th falls on a Friday or a day the business office is closed, service will be suspended on the following business day. Any account that is suspended for non-payment will be assessed a $28.00 restoral fee. Service will be restored during regular business hours, after the account balance and restoral fee have been paid in full. The Prompt Payment Contract will be in effect for one year. If during the year service is suspended for non-payment, the contract will be extended until a satisfactory credit rating has been established. In lieu of the Prompt Payment Contract, subscribers may elect to enroll in the Automatic Payment Plan. NON-SUFFICIENT FUNDS: All checks returned for non-sufficient funds will be assessed a $30.00 surcharge, plus any applicable taxes. RECOVERY OF SUBSCRIBER DEBT TO THE COOP: The Company will collect any written off balances from the subscriber’s standard capital credit account. Subscribers will be assessed a 40% discount on their standard capital credit account when used for the recovery of a debt to the Cooperative. Prompt Payment Contract:*I agree to have my account paid in full by 12 noon on the 15th of the month in which service is rendered. I understand that if payment is not received in full by 12 noon on the 15th of the month in which service is rendered, all services will be suspended allowing only 911 and 611 (business office) calls. When the 15th falls on a day the business office is closed, service will be suspended on the following business day. I also understand that if my account is suspended for non-payment, a $28.00 restoral fee will be assessed. Service will be restored when the account balance and restoral fee are paid in full. I understand this agreement will be in effect for one year and if during the year service is suspended for non-payment, the contract will be extended until a satisfactory credit rating has been established. I agree Automatic Payment Plan:*Automatic Payment Plan subscribers will continue to receive a monthly bill. Automatic deduction will occur on the 15th of the month. When the 15th falls on a day the business office is closed, the deduction will occur on the following business day. The Automatic Payment Plan will continue in effect until TrioTel receives notification of termination. A Non-Sufficient Funds notice from the bank may result in removal from the Automatic Payment Plan. Automatic Payment requests will not be processed without a voided check. Please submit a voided check to the TrioTel business office.YesNoAutomatic Payment PlanName of Bank:*Account Type:*CheckingSavingsBank Routing Number (first set of numbers):*Bank Account Number (second set of numbers):*Authorization:*I authorize TrioTel and the financial institution named to initiate entries to my checking/savings account. This authorization will remain in effect until TrioTel has received notification of termination and TrioTel has confirmed to me that the Automatic Payment Plan has been terminated. TrioTel reserves the right to cancel my use of the Automatic Payment Plan. I agree End of Automatic Payment Plan Billing Name and Address Notification The FCC requires TrioTel Communications, Inc., under certain circumstances, to release the Billing Name and Address (BNA) of telephone customers to telecommunications service providers. The main reason for releasing BNA information is to ensure proper billing for certain types of calls. For instance, calls such as collect, third number billed, or calling card calls may be carried by an interexchange carrier who is not your presubscribed interexchange carrier or who does not have a billing contract with our company. Under these circumstances, the carrier does not know who to bill the call to, and therefore, must request the BNA from our company in order to bill the call. We must provide the information to the requesting carrier. BNA can also be released to telecommunications service providers for other reasons, such as verification for presubscription, servicing your account, to prevent fraud, or when you move from one location to another. If you have an unlisted or non-published telephone number, you have a choice. If you do not want your BNA released by TrioTel, please contact the business office within 30 days. If you provide us with such notification, your ability to make calling card calls, to receive collect calls, or third number billed calls could be denied. Wire Maintenance Protection Plan:*$2.75 per month. Covers the diagnosis, maintenance and repair on existing telephone, Internet and video wiring and jacks in the home. Includes replacement and programming on TrioVision remote controls. Wiring not done to industry standards will not be covered by wire maintenance; nor diagnosis, maintenance or repairs to customer owned equipment such as telephones, televisions, computers or other electronic equipment. Wire maintenance does not cover labor charges associated with service calls. Other restrictions may apply.Yes = $2.75NoPhone Book:*Would you like a TrioTel Phone Book?YesNoTelephoneTelephone service:*Subscribing to telephone service qualifies you to become a member of the Cooperative.YesNo $32.00 = $32.00 one-time Activation Fee $35.00 = $35.00 per Month for Local Telephone Service (includes federal, state, city and other regulatory fees) Backup Battery:*Over a fiber-optic connection, a backup battery and power supply unit (backup battery unit) is needed to power your TrioTel telephone service in the event of a power outage. Without a backup battery or alternate backup source, such as a generator, you will not be able to make any calls, including emergency calls to 911. Cordless telephones require power and may not function during a power outage. TrioTel recommends you have at least one corded telephone connected directly to an active phone jack for emergency use in the event of a power failure. The backup battery unit TrioTel has provided is expected to last up to 8 hours on standby power during an outage. The actual length of time that your telephone service will be available during a power outage depends on many variables, including, but not limited to: the amount of phone usage when the service is utilizing power from the backup battery; whether the backup battery is properly installed and charged; the condition and age of the backup battery; and the amount of prior usage of the battery. In complying with the FCC rule FCC-15-98, TrioTel now offers an optional 24-hour backup battery and power supply unit, installation of the backup battery unit is included when purchased and installed at the time of telephone service connection. Please follow the instructions included with your backup battery unit for proper use, storage, and care of the battery; for details on the warning indicator lights and battery replacement; and for testing your battery. The backup battery unit TrioTel has provided performs self-tests and is monitored for life expectancy. TrioTel does not supply any warranty on the backup battery units. Yes, I would like to purchase a 24-hour backup battery unit for $135.74. = $135.74 one-timeNoLong DistanceIntraLATA Long Distance Provider*Calls within the 605 area code. Please select NO LONG DISTANCE if you do not need long distance service.9999 - NO LONG DISTANCE0071 - Broadwing Comm.0211 - Global Crossing0222 - MCI/Worldcom0223 - Primus0244 - UCN0284 - Lifeline comm0288 - AT&T0297 - VarTec0432 - CenturyLink0444 - Global Crossing0457 - Dial & Save (Excel)0555 - Worldcom Inc.0603 - Incomnet Comm Corp0629 - WorldxChange0636 - Clear Choice Comm. (VarTec)0649 - Working Assets0725 - McLeod USA0732 - AT&T0752 - Excel0795 - Caprock Telemanagement0810 - Winstar Communications0811 - VarTec Telecom, Inc.0813 - PowerNet Global Comm.0832 - Telecom USA0834 - WorldxChange0865 - Express0888 - MCI/Worldcom0948 - Broadwing Comm.5102 - WilTel Communications5200 - WorldxChange5335 - WorldxChange5722 - Southwestern Bell LD5792 - SBC Long Distance5957 - Lightyear Network Solutions6112 - ACN Communication Services6398 - Trans National Comm. Intl6837 - Long Lines Metro, LLCInterLATA Long Distance Provider*Calls outside the 605 area code. Please select NO LONG DISTANCE if you do not need long distance service.9999 - NO LONG DISTANCE0071 - Broadwing Comm.0211 - Global Crossing0222 - MCI/Worldcom0223 - Primus0244 - UCN0284 - Lifeline comm0288 - AT&T0297 - VarTec0432 - CenturyLink0444 - Global Crossing0457 - Dial & Save (Excel)0555 - Worldcom Inc.0603 - Incomnet Comm Corp0629 - WorldxChange0636 - Clear Choice Comm. (VarTec)0649 - Working Assets0725 - McLeod USA0732 - AT&T0752 - Excel0795 - Caprock Telemanagement0810 - Winstar Communications0811 - VarTec Telecom, Inc.0813 - PowerNet Global Comm.0832 - Telecom USA0834 - WorldxChange0865 - Express0888 - MCI/Worldcom0948 - Broadwing Comm.5102 - WilTel Communications5200 - WorldxChange5335 - WorldxChange5722 - Southwestern Bell LD5792 - SBC Long Distance5957 - Lightyear Network Solutions6112 - ACN Communication Services6398 - Trans National Comm. Intl6837 - Long Lines Metro, LLCAuthorization:*I hereby authorize TrioTel to implement the long distance carrier of my choice for IntraLATA and InterLATA. I understand that it is my responsibility to contact the long distance provider chosen to set up billing information and an appropriate calling plan. I agree Pic Freeze*A Primary Interexchange Carrier (PIC) Freeze will prevent a Long Distance provider initiated change being made to your account. If you wish to make any changes to your long distance provider(s), you must contact TrioTel to authorize this change. There is no charge for this service. To lift the PIC Freeze, simply complete the Lift PIC Freeze Request.NoYesCalling FeaturesMost Popular Calling Features: $3.90 = $3.90 Caller ID Name & Number $0.95 = $0.95 Call Waiting with Cancel Call Waiting $0.50 = $0.50 Call Forwarding $0.50 = $0.50 Three-Way Calling $2.95 = $2.95 Voice Mail Avoid Missed Calls: $4.95 = $4.95 Find Me Service $2.25 = $2.25 Call Forward Busy $2.25 = $2.25 Call Forward No Answer $1.50 = $1.50 Automatic Recall *69 Maintain Privacy & Limit Interruptions: $3.00 = $3.00 Non-Published Number $1.00 = $1.00 Non-Listed Number $0.95 = $0.95 Caller ID Blocking $1.50 = $1.50 Anonymous Call Rejection $2.75 = $2.75 Telemarketer Call Screening Be in Control of Your Long Distance Charges: No Charge Toll Denial $1.95 = $1.95 Toll Restriction (On/Off) $1.95 = $1.95 Toll (Pin) Restriction No Charge 900 Blocking No Charge Collect Call Block $4.95 = $4.95 International Call Blocking Personalize Your Calls: $1.50 = $1.50 Selective Call Acceptance $1.50 = $1.50 Selective Call Forwarding $1.50 = $1.50 Selective Call Rejection $1.50 = $1.50 Distinctive Ring/Call Waiting $1.95 = $1.95 Teen Line Time Saving Calling Features: $0.50 = $0.50 Speed Dial 8 $0.95 = $0.95 Speed Dial 30 $1.50 = $1.50 Automatic Call Back *66 Safety Features: $0.95 = $0.95 Warm Line Calling Feature Combinations: $3.45 = $3.45 Voice Mail with E-forward $5.75 = $5.75 Caller ID with Voice Mail $5.80 = $5.80 Caller ID/Call Waiting includes Caller ID and Call Waiting Lifeline Program Lifeline is a federal program that lowers the cost of telephone service, bundled telephone-broadband, and broadband only service that meets minimum standards. Lifeline provides a discount of $9.25 per month for eligible low-income subscribers and is non-transferable. Customers can qualify for one discount per household if their income is at or below 135% of the federal poverty guidelines or by participation in one of the following programs: Federal Public Housing Assistance (FPHA) Supplemental Nutrition Assistance Program (SNAP)(Food Stamps) Medicaid Supplemental Security Income (SSI) Veterans Pension or Survivors Pension Benefit Applicants will be required to provide proof of eligibility and re-certify annually. Toll Blocking service prevents the placement of all long distance calls for which a subscriber would be charged. Toll blocking is available at no cost. Customers can apply for Lifeline by mail or online at CheckLifeline.org. TrioVisionTrioVision Service:*YesNoTV service only fee*Customers who subscribe to TV service without telephone or internet service will pay a monthly TV service only fee of $20.I'm only subscribing to TV service = $20.00 per monthI'm subscribing to telephone and/or internetA set top box (STB) is needed for each TV to receive TrioVision service. For wall mounted TVs, subscribers are responsible for providing shelving units or TV stands for each STB. Up to three STBs are included with price. More may be indicated under Programming (+$3.95/each).Please check all that apply (up to three):* Living Room Family Room Kitchen Bedroom 1 Bedroom 2 Basement Other 1 Other 2 Other 3 Other 1*Other 2*Other 3*Programming:Package pricing includes STBs and remote controls for three TVs. Retransmission Fee to Broadcasters - $17.00 = $17.00 per month Simply Right Package (Basic package. Includes 27 channels.) - $20.95 = $20.95 per month Number of channels available in programming packages subject to change due to contract requirements and negotiation agreements. The Retransmission Fee is passed along by the local broadcasters. It is subject to increase or decrease yearly, according to programming negotiation agreements. TrioTel works with other cable companies across the United States to reason with broadcasters for lower fees and will continue to advocate for the betterment of our subscribers. Preferred Choice Channels (Add an additional 81 channels along with 50 Stingray Music channels) - $40.00 = $40.00 per month Additional Set Top Box (price is per box) - $3.95 per month = $3.95*#79 Number of Additional STBs (0-99):*Please check all that apply:* Living Room Family Room Kitchen Bedroom 1 Bedroom 2 Other 1 Other 2 Other 3 Other 1*Other 2*Other 3*Enhance your TV viewing High Definition (HD) Equipment - Watch 81 HD Channels on all household televisions. Must subscribe to Preferred Choice Channels. - $10.95 = $10.95 per month Whole Home Digital Video Recorder (DVR) - Pause, Rewind and Record LIVE TV. Set up, manage and access all recordings from any TV in the household. - $10.95 = $10.95 per month Save Me Now! HD and DVR -Enjoy both HD and DVR at a savings. - $15.95 = $15.95 per month Timeshift Drive - Pause and Rewind LIVE TV, without a DVR. Compatible with Amino 140 STBs. While supplies last. Restrictions may apply. - $1.95 = $1.95 per drive per month On-screen Caller ID - Displays incoming calls on your TV. View your call history. - see Calling Features list for Pricing On-screen Voice Mail - Notification of Voice Mail on your TV. Playback, save or delete voice mail messages. - see Calling Features list for Pricing Premium Movie ChannelsMust subscribe to Preferred Choice Channels. HBO (includes 5 HBO Channels) - $11.95 = $11.95 per month Showtime (includes 5 Showtime Channels) - $10.95 = $10.95 per month Cinemax (includes 4 Cinemax Channels) - $10.95 = $10.95 per month Starz!/Encore Pak (includes 4 Starz! & 7 Encore Channels) - $10.95 = $10.95 per month Watch More and SaveMust subscribe to Preferred Choice Channels. The TrioVision DOUBLE Deal (includes choice of 2 Premium Movie Channels) - $19.95 = $19.95 per month The TrioVision TRIPLE Deal (includes choice of 3 Premium Movie Channels) - $27.95 = $27.95 per month The TrioVision HOMERUN STEAL Deal (includes all 4 Premium Movie Channels) - $33.95 = $33.95 per month More Channel OptionsMust subscribe to Preferred Choice Channels. Playboy Channel - $10.95 = $10.95 per month NFL Red Zone - Available to Residential Customers only. - $49.95 = $49.95 one-time per season Extras Watch TV Everywhere - Data Charges may apply. Watch select TrioVision programming on any device with Internet access. It is recommended to connect to wi-fi before accessing content. ManageMyTVs app - NO CHARGE. Manage your TrioVision system with your iPhone, iPad or Android device. Parental Controls - NO CHARGE. Control TV viewing by channel, by rating or by time. Option to hide or view blocked content. Restrictions can be lifted at any time with your PIN. Access the Apps Menu for: Games- test your skills with a game of Memory, Solitaire or Sudoku. Availability restrictions apply. Weather- view the current weather, forecast and radar for Sioux Falls, Mitchell and Madison. What’s Hot- see what current programming is the ‘most watched’ among TrioVision subscribers. Installation and Equipment TrioVision installation - $99.00 Installation includes the wiring of one jack. A $25.00 charge will apply for each additional jack; including new jacks or existing jacks that require new wiring. TV’s must be in place. TrioVision service is subject to a one year contract. Additional set top box equipment is subject to a six month contract. Additional charges may apply if subscriber requires an HPNA box or if subscriber requests extra Category 5 cable. Subscriber is responsible to provide installers with easy access to TV jacks. Entertainment centers and decorations may need to be moved prior to installation. Set Top Boxes, power supply cords and remotes are the property of TrioTel and must be returned when services are disconnected. If they are not returned or are damaged, subscriber will be responsible for the cost of the equipment. Installation and Equipment Agreement:*I understand the TrioVision installation fee is $99.00 and includes the wiring of one jack. If I request additional jacks installed or wired, additional charges will apply. If I cancel TrioVision service before my contract ends, I will be charged an early termination fee. When services are disconnected, I will return all TrioVision equipment to avoid additional charges. When connecting to both TrioVision and High Speed Internet, only one $99.00 installation/activation fee will apply, and only the wiring of one jack will be included. I agree TrioVision Subscriber Agreement:*This agreement is between TrioTel Communications, Inc. (TrioTel), duly authorized and existing under the laws of the State of South Dakota with its office at 330 South Nebraska Street, PO Box 630, Salem, SD 57058, and the undersigned subscriber. TERMS OF SERVICE: The term of this contract is one year (365 days) from the date of installation. Additional set top box equipment is subject to a six month contract. If TrioVision service is terminated before one year or if additional set top box equipment is removed before six months, subscriber agrees to pay an early termination fee, up to $250.00. BILLING TERMS: All monthly charges are to be paid in advance, or at the time billed by TrioTel, and no portion of such monthly charges will be refundable, unless for services rendered. TrioTel will provide subscribers with a statement for each billing cycle. Statements will reflect: payments, credits, purchases, and any other charges to the account for all services received, the amount owed to TrioTel, and the date the payment is due. Payment of an outstanding balance is due in full by the date due. If we do not receive payment in full by the date due on the billing statement, TrioTel has the right to deactivate all services. Subscribers should be advised that the first bill may be larger than normal, and may include: activation/installation fees, current month’s prorated monthly charges along with next month’s monthly charges, equipment purchases, costs for labor and materials during installation, plus any other charges or miscellaneous fees. PAYMENT FOR SERVICE: By signing this agreement, as a subscriber you agree to pay for all TrioVision subscriptions, pay-per-view or video on demand purchases (as available), and other services required by this Agreement or which are ordered by you or anyone who uses your TrioVision system, whether with or without your permission, through all periods until the subscription and other services are canceled. Subscriber is responsible for all pay-per-view or video on demand purchases and will not be issued credit for duplicate programming purchases, failure to record purchased programming, interruptions due to power outages or equipment failure, or any other instance in which the outage, interruption or error was beyond the reasonable control of TrioTel. It is the subscriber’s responsibility to maintain and enforce the pay-per-view, video on demand, and parental locks on the interactive program guide. TrioTel may, based on credit score or payment history with us, require a deposit or payment in advance for services, limit the services available, or take other action to secure subscriber obligation to TrioTel as a condition of your continued receipt of services. FEES AND CHARGES: In addition to the amounts due for TrioVision programming services, subscriber agrees to pay the following charges, if applicable, in the amounts stated, as amended from time to time: ACTIVATION/INSTALLATION FEE $99.00: Subscriber agrees to pay the Activation/Installation Fee prior to the activation/installation of TrioVision service. Additional charges may apply if subscriber requires an HPNA box or if subscriber requests extra Category 5 cable. A $5.00 programming fee may apply if subscriber changes premium movie channels and/or package plans. TV JACK FEE $25.00: TrioVision activation/installation includes the wiring of one TV jack. Subscriber agrees to pay the TV Jack Fee for each additional jack; including new jacks or existing jacks that require new wiring. If a set top box can be plugged into an existing jack and the TV works, no fee will apply. VACATION FEE $25.00: TrioVision service may be put on vacation for a minimum of three months. Subscriber agrees to pay the Vacation Fee when TrioVision service is restored. LATE PAYMENT FEE $2.00 OR 1 ½% OF THE OUTSTANDING BALANCE: Subscriber agrees to pay the Late Payment Fee if payment is received after the date due on the billing statement. Subscribers on the Prompt Payment Plan will not receive a late notice, instead services will be suspended if payment is received after the date due on the billing statement. RESTORAL OF SERVICE FEE $28.00: Subscriber agrees to pay the Restoral of Service Fee if TrioVision programming service has been suspended and wishes service to be restored, in addition to bringing the account up to date by payment in full of any outstanding balances, fees, and charges. RETURNED PAYMENT FEE $30.00: Subscriber agrees to pay the Returned Payment Fee if the bank or other financial institution on which payment is drawn refuses to pay TrioTel for any reason, and the check, money order, or any other instrument is returned to TrioTel unpaid. EQUIPMENT AGREEMENT: As a subscriber to TrioVision you agree that all equipment installed in or on the premises is the property of TrioTel. You agree that you will not deliberately alter, tamper with, or remove equipment, and you will exercise reasonable care to prevent damage or loss of the equipment. If the equipment is tampered with, lost, stolen, or not returned, you agree to pay TrioTel for the repair or replacement of the equipment. If it is necessary for TrioTel to commence legal proceedings for the recovery of such damages, any amounts due under this Agreement or by law, or for the recovery of the TrioVision equipment, you agree to pay any unpaid balance due TrioTel, legal costs of collection, plus 1 1/2% interest per month. The purchase and replacement of remote batteries in the future will be your responsibility. If a remote is lost or damaged, replacement remotes can be purchased from TrioTel. TrioVision equipment is and shall remain the property of TrioTel. Upon termination of TrioVision service, the equipment must be returned to an authorized representative of TrioTel in proper undamaged condition within 72 hours. You agree to return all equipment to the TrioTel Business Office located at 330 S. Nebraska St., Salem, SD, or you will otherwise make arrangements for an authorized TrioTel representative to recover the TrioVision equipment from your residence by appointment between 8:00 a.m. and 5:00 p.m. Monday through Friday. In the event of a software upgrade, hardware failure, or factory restoral your DVR set top box may lose any or all content recorded. TrioTel is not responsible for lost recordings, pay-per-view or video on demand purchases. Service limitations and restrictions may apply in certain areas. Pricing may vary and is subject to change. I have read and agree to the terms and conditions of this TrioVision Subscriber Agreement. High Speed InternetHigh Speed Internet Service:*TrioTel proudly holds the honor of being the first broadband provider in South Dakota to deploy services via fiber optic network to 100% of its subscribers. Subscribing to Internet service qualifies you to become a member of the Cooperative. ResidentialBusinessNo Internet ServiceHigh Speed Internet Service:*TrioTel proudly holds the honor of being the first broadband provider in South Dakota to deploy services via fiber optic network to 100% of its subscribers. Subscribing to Internet service qualifies you to become a member of the Cooperative. ResidentialBusinessNo Internet ServiceOperating System(s)*Check all that apply. Windows 7 Windows 8 Windows 10 MAC OS X Unknown Other Other Operating System:*Select the Internet speed that best fits your needs:*Multiple devices or high demand applications such as streaming HD, video conferencing, and online gaming may require a higher-speed Internet connection. Pricing is based on Internet speed, not usage. 25M/3M Internet Service $39.95 = $39.95 per month50M/10M Internet Service $64.95 = $64.95 per month100M/10M Internet Service $94.95 = $94.95 per monthSelect the Internet speed that best fits your needs:*Multiple devices or high demand applications such as streaming HD, video conferencing, and online gaming may require a higher-speed Internet connection. Pricing is based on Internet speed, not usage. 25M/3M Internet Service $49.95 = $49.95 per month50M/10M Internet Service $74.95 = $74.95 per month100M/10M Internet Service $104.95 = $104.95 per monthSelect the Internet speed that best fits your needs:*Multiple devices or high demand applications such as streaming HD, video conferencing, and online gaming may require a higher-speed Internet connection. Pricing is based on Internet speed, not usage. 30M/10M Internet Service $64.95 = $64.95 per month50M/10M Internet Service $84.95 = $84.95 per month100M/10M Internet Service $104.95 = $104.95 per monthCreate your Username and Password:* I will actively use my TrioTel email address?YesNoUsername/Email Address:*Residential Internet service includes one email address and 24 hour tech support.Password:*Your password must be a minimum of 8 characters, cannot contain the username (forward or backward), nor the word “password”, must include letters and numbers, may use upper or lower case letters, and all letters, numbers, and symbols are allowed, as well as spaces.Business Internet service includes four email addresses and 24 hour tech support. Additional email addresses available.Username/Email Address 1:*Password 1:*Username/Email Address 2:Password 2:Username/Email Address 3:Password 3:Username/Email Address 4:Password 4:Other $2.00 = $2.00 per month. Additional username/email address (complete below) $86.00 = $86.00 one-time High-Performance Wireless Router (up to 20 wireless devices - mid range wifi coverage) $320.00 = $320.00 one-time Ultra High-Performance Wireless Router (40+ wireless devices - high range wifi coverage) $103.00 = $103.00 one-time Surge Protector (Recommended for Ultra High-Performance Wireless Router) Note: A wireless device may include: laptop, printer, smart device, smart phone, smart TV, tablet, video game console. Consider this when purchasing a router. Router price includes installation of router at time of Internet install. Pricing subject to change. Extras Static IP Address Vanity Email Address Basic Computer Classes - topics vary Equipment Lease Program Surveillance and Monitoring Cameras Additional Username/Email Address:*Additional Email Password:*Activation Fee: $99.00*I understand the Activation Fee is $99.00 and includes two labor hours for installation and the wiring of one jack. A $25.00 charge will apply for each additional jack; including new jacks or existing jacks that require new wiring. If the installation exceeds two labor hours, additional charges may apply. When connecting to both High Speed Internet and TrioVision, only one $99.00 activation/installation fee will apply, and only the wiring of one jack will be included. I agree TrioTel High Speed Internet Subscriber Agreement*Sexually explicit material can be obtained over the Internet. TrioTel Communications, Inc. will not be responsible for any activity in which you, as the user, conduct in your Internet travels. Parents may want to obtain software that will disable this type of activity. This agreement is between TrioTel Communications, Inc. (TrioTel), duly authorized and existing under the laws of the State of South Dakota with its office at 330 South Nebraska Street, PO Box 630, Salem, SD 57058, and the undersigned Customer. SERVICE WARRANTIES: With respect to the service provided, TrioTel makes no warranties of any kind, expressed or implied, including any implied warrantee or merchantability or fitness of this service for a particular purpose. TrioTel takes no responsibility for any damages suffered by the customer, including but not limited to: loss of data from delays, non-deliveries, mis-deliveries, or service interruptions caused by TrioTel’s own negligence or customer's errors and/or emissions. ACCEPTABLE USE: TrioTel service may only be used for lawful purposes. Materials and/or transmissions in violation of any local, state, or federal regulations are strictly prohibited. This includes, but is not limited to: 1. Material legally judged to be threatening, abusive, obscene, libelous, defamatory, or pornographic. 2. Transmitted or downloaded information, software or other material that is protected by copyright or other proprietary right without permission of the person owning that protected right. 3. Information transmitted through software that contains a virus, worm, Trojan Horse, SPAM, bulk email, or other harmful component. 4. Adding, removing, or modifying identifying network heading information (aka “spoofing”) in an effort to deceive or mislead. 5. Any impersonation of another person using forged headers or other improper identifying information or engaging in any activity which would compromise customer privacy or system security or gain access to any system or data without required permission (e.g. “hacking”) of the owner. USE OF INFORMATION: Use of any information obtained via this service is at the customer’s risk. TrioTel specifically denies any responsibility for the accuracy or quality of information obtained through its services. TrioTel disclaims any liability for any act or omission with regard to Internet content the customer finds objectionable or unsuitable. TrioTel does not screen in advance any specific content, and reserves the right, but does not assume the responsibility, to block or limit access to content that violates our terms and conditions. INAPPROPRIATE USGE: TrioTel or other relevant authorities may determine inappropriate usage of this account and the privilege may be revoked at TrioTel’s discretion. Should this occur, the customer will be notified in writing of this action. TrioTel also holds the right to electronically monitor its service and to disclose any information it deems necessary to satisfy any legal or operational requirements. SHARING OF PASSWORDS OR ACCOUNTS: The resale or otherwise sharing of TrioTel service account information or passwords, or any other associated services by any and all means is strictly prohibited (unless approved in advance in writing by TrioTel). The customer may not resell or redistribute TrioTel service to any third party via any means, including but not limited to, wireless technology. As well as any engagement in any activity which would result in third-party charges to TrioTel. Violators are subject to the cancellation of service without prior notice. By using TrioTel service, the customer agrees to hold TrioTel harmless for content accessed when using the Internet service. CHANGE OF STATUS: TrioTel will occasionally require new registration and account information by the customer to continue this service. In addition, the customer shall notify TrioTel in writing of any changes in the account information. Any IP address assigned to a customer on any basis remains the property of TrioTel and may not be appropriated for any use other than as intended by TrioTel. LIMITATION OF LIABILITY: Neither party shall be liable to the other for any loss, damage, liability, claim or expense arising out of or in relation to this agreement or the provision of service or equipment, however caused, whether grounded in contract, tort (including negligence), or theory of strict liability. The parties agree to work in good faith to implement the purpose of this Agreement, but recognize the network connection and services to be provided by TrioTel could not be made available under these terms or other similar terms without a substantial increase in cost if the parties were to assume a greater liability to each other. BILLING TERMS: The monthly billing will include the current month’s Internet charges as well as any of the past month’s usage-based fees, such as: hourly service charges, equipment purchases, plus any other charges or miscellaneous fees. Subscribers should be advised that the first bill may be larger than normal, and may include: activation/installation fees, current month’s prorated monthly charges along with next month’s monthly charges, equipment purchases, costs for labor and materials during installation, plus any other charges or miscellaneous fees. All fees are non-refundable. The monthly service fees are independent of the amount of traffic or systems accessed by users at the customer's location. TrioTel reserves the right to evaluate on an individual account basis bandwidth or hardware utilization. Excessive bandwidth or hardware usage that adversely affects TrioTel’s ability to provide its Internet or any other service may result in additional account management and fees. ELECTRONIC COMMUNICATIONS PRIVACY ACT (ECPA) NOTICE: Customers are hereby notified that TrioTel does NOT offer the same degree of privacy for email or files that the customer expects from regular paper mail. DIGITAL MILLENNIUM COPYRIGHT ACT POLICY: When TrioTel receives a notice from a copyright holder or its authorized representative regarding an alleged violation of law by someone using an IP address identified as belonging to TrioTel, the following actions will be initiated: 1. TrioTel personnel will review the address to determine whether the address is in use by TrioTel. 2. If the address is assigned and used by TrioTel, personnel will attempt to identify the user. If the offender cannot be identified, TrioTel will notify the copyright holder or its agent accordingly. 3. If the offender is identified, TrioTel will notify the offender by telephone, email or in writing of the offense. 4. Any copyright violations may result in termination of service. TrioTel complies with all open Internet guidelines as set forth by the FCC. Please see our Network Management Policy online at www.triotel.net for more information. These Terms and Conditions supersede all previous representations, understandings or agreements and shall prevail notwithstanding any variance with terms and conditions of any order submitted. Use of TrioTel services constitutes acceptance of these Terms and Conditions. I have read and agree to the terms and conditions of this TrioTel High Speed Internet Subscriber Agreement. Signature* First Last = $99.00 one-timeMonthly Charges & One-Time Charges don't include tax Estimated Fees and Charges per month one-time fees & setup charges *If your TV jacks are not up to date, a fee of $25 will be added for each TV jack.