CenturyLink Wholesale | Wireless | Wireless Local Number Portability (WLNP)

EASE Access Request Form

Applicant Information: (If your company already has an identified EASE/VFO ID Administrator, please request access through them; otherwise, all information below must be filled out for request to be processed.)
Request Type:
First Name:
Middle Initial:
Last Name:
Telephone:
Fax:
Company:
Email Address:
Department:
Company Street Address:
Company City/State/Zipcode:
CCNA/ACNA (for ASR access):
Company Code/OCN (for LSR access):
Manager's Name:
Manager's Email Address:
Manager's Telephone:
EASE Application Action:
NON-DISCLOSURE AGREEMENT:Your individual sign on is to be kept confidential and in no way shared with any other person. If an individual in your department or any other department needs access, they must submit a request through their manager. Be advised that divulging your id/password is a violation of the non-disclosure agreement and could result in disciplinary action and/or loss of system access. (DATA SECURITY) NOTICE: Customer shall be responsible for all acts and omissions of the employee named above in connection with access to the system, regardless of the employee's employment status with Customer, until CenturyLink has received and processed the Request Form deleting the employee's system access. If you need more information or have questions, please e-mail helpdesk.ease@CenturyLink.com.