AT&T G3 manual Issue 2 April 1996 A-7

PA001 Form

PA001 Administration Request Form

Switch Information

Complete one group of fields for each PBX. If you have more than 5 PBXs, ph this page before you begin.

PBX # _______
Switch Name: ______________________________	LDN: (_____) _____-__
Switch Release: ____________________________	Alarm ID: ___________
Customer Name: ____________________________	Modem Type:
Customer Location: _________________________	Data Module (9
Dial String: ________________________________	Analog (1200)
PBX # _______
Switch Name: ______________________________	LDN: (_____) _____-__
Switch Release: ____________________________	Alarm ID: ___________
Customer Name: ____________________________	Modem Type:
Customer Location: _________________________	Data Module (9
Dial String: ________________________________	Analog (1200)
PBX # _______
Switch Name: ______________________________	LDN: (_____) _____-__
Switch Release: ____________________________	Alarm ID: ___________
Customer Name: ____________________________	Modem Type:
Customer Location: _________________________	Data Module (9
Dial String: ________________________________	Analog (1200)
PBX # _______
Switch Name: ______________________________	LDN: (_____) _____-__
Switch Release: ____________________________	Alarm ID: ___________
Customer Name: ____________________________	Modem Type:
Customer Location: _________________________	Data Module (9
Dial String: ________________________________	Analog (1200)
PBX # _______
Switch Name: ______________________________	LDN: (_____) _____-__
Switch Release: ____________________________	Alarm ID: ___________
Customer Name: ____________________________	Modem Type:
Customer Location: _________________________	Data Module (9
Dial String:	GAnalog (1200)

Issue 2 April 1996 A-7