WTI Customer Update Form Company Name Street Address City State Select Value Alaska Alabama Arkansas ARIZONA CALIFORNIA COLORADO CONNECTICUT DISTRICT OF COLUMBIA DELAWARE FLORIDA GEORGIA GUAM HAWAII IOWA IDAHO ILLINOIS INDIANA KANSAS KENTUCKY LOUISIANA MASSACHUSETTS MARYLAND MAINE MICHIGAN MINNESOTA MISSOURI MISSISSIPPI MONTANA NORTH CAROLINA NORTH DAKOTA NEBRASKA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEVADA NEW YORK OHIO OKLAHOMA OREGON PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VIRGINIA VIRGIN ISLANDS VERMONT WASHINGTON WISCONSIN WEST VIRGINIA WYOMING Zip Name of person who does purchasing Purchaser's phone number Name of Accounting Contact Accounting Contact phone number Would you like invoices sent via e-mail? Accounting Contact's e-mail address How would you like to be notified of specials? Select Value fax email call Fax Number to send specials E-mail address to send specials Manufacturer you are most interested in Select Value ATT/AVAYA/LUCENT COMDIAL NEC/NITSUKO NORTEL TOSHIBA OTHER Secondary Interest Select Value ATT/AVAYA/LUCENT COMDIAL NEC/NITSUKO NORTEL TOSHIBA Other Interests Comments