CSI Request Form - Completion Instructions
Intro This document will step the user through the completion of the Birch CSI Request Form (also known as CSR). Page one is the layout of the form. Page two and three provide a description of what is required within each field.

Form Layout
Field Description The following provides a description for what is being asked within each field of the CSI Request Form.

Field Description Field Number Field Definition
ILEC Territory 1 The Local Exchange Carrier which services the area where the customer's service location resides.
BIRCH/IONEX 2 Is the current local provider Birch Telecom or Ionex Telecom (Ionex Telecom was acquired by Birch Telecom).
Requesting CLEC 3 Name of company requesting the Customer Service Information.
Initiator Name 4 Who within the requesting company is placing this request and will serve as the company contact. This may be an individual, work team, or office name, as appropriate.
Initiator Contact Number 5 Initiator's business contact number.
Fax Number 6 Initiators business fax number. Fax Number, Email Address, or both should be entered. If Fax is not an appropriate means of distributing Customer Service Information place an N/A in this field.
Email Address 7 Initiators business email address. Email address, Fax Number, or both should be entered. If email is not an appropriate means of distributing Customer Service Information place an N/A in this field.
Name 8 End User Account Name.
Service Address 9 End User Service Location Address.
Apt or Suite Number 10 End User Service Location Apartment, Suite, Room #, etc.
City 11 End User Service Location City.
State 12 End User Service Location State.
Zip Code 13 End User Service Location Zip.
Type of Service 14 The end user class of service. Residential or Business.
Account Number 15 The existing Birch/Ionex customer account Number.
LOA on File 16 See Section IV B. of CLEC-to-CLEC and CLEC-to-ILEC migration guidelines.
WTN 17 Include all TN's that will be converting and need to be included with the Customer Service Information.
Terminals 18 Select Yes or No as applicable.
Terminal Number 19 Terminal Telephone Numbers and Terminal Number( example 001, 002, etc.
Comments 20 Beginning and ending number range of DID's can be entered here. Any additional information that would be of assistance to Birch Telecom in fulfilling the Customer Service Information should also be included.

Submit Once all entries have been completed, select the Submit key to release the information to Birch Telecom for processing of the request. Please allow 3 business days for receipt.

The Reset key will delete all entries of the form allowing the requester to re-enter the data from scratch. Use of this key will NOT submit the request to Birch Telecom.