Support
Leave Us A Review!
Hotspots
Webmail
Web Self-Care
New Customer Sign Up
Bill Pay
Refer-a-Friend
BT Cares
Shelburne Construction
Residential Internet Service
Residential TV & Bundles
Residential Phone
Smarter TV
Contact Us
BT Business Services
Residential Internet Service
Residential TV & Bundles
Residential Phone
Smarter TV
Contact Us
BT Business Services
Testing
Landlord Letter of Permission
For homeowners, landlords and property managers
"
*
" indicates required fields
Property Owner Information
Name
*
First
Last
Email
*
Phone
*
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
As the Owner or Duly Authorized Manager of the property located at (enter street address below) I (we) hereby authorize Champlain Broadband LLC, DBA Burlington Telecom, to install communication cable and equipment and any internal wiring necessary to provide voice, internet and cable services to the property. This form provides permission for all units in a multi-dwelling. I also agree to the installation for additional properties I own listed below.
Tenant Information
Name
*
First
Last
Email
Phone
*
Address
*
Street Address
Owner Occupancy?
*
Yes
No
Housing Type
*
Single Family
Duplex
Condo
Multi-Unit
Special Instructions
Your Digital Signature
*
ACCEPTANCE OF TERMS AND CONDITIONS
The typed name above is considered an official signature. By providing your signature above, you agree to all terms and conditions of this Agreement. For the purpose of this agreement it is understood that by signing this LETTER OF AUTHORIZATION in no way obligates the property owner to accept communication service from Burlington Telecom. It is further understood that no such inside wiring or installation will take place until a service order is initiated by the property owner or tenant thereof. By signing this agreement, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. This is consent to be legally bound by this Agreement’s terms and conditions.
Need More?
Yes
No
Additional Properties
Address
Street Address
Housing Type
Single Family
Duplex
Condo
Multi-Unit
Address
Street Address
Housing Type
Single Family
Duplex
Condo
Multi-Unit
Address
Street Address
Housing Type
Single Family
Duplex
Condo
Multi-Unit
Phone
This field is for validation purposes and should be left unchanged.
Translate »
We use cookies to ensure that we give you the best experience on our website.
Ok
