Form L – IBN for Shared HNI Return

Form Name *

IBN(s) *

Please select one or more.

Company IBN is currently held by *

Effective Return Date *//

The IBN has beenwas previously deployed:

Contact Name *

First

Last

Phone

Email *

Date

NOTE: This code enables mobile terminals/users to roam among domestic and international networks and provides for the exchange of subscription and billing information for the visiting mobile station. Without this code, your company’s mobile users may be unable to roam out of their service territory or on another carrier’s network. Once returned, the number may not be available for reassignment and the process will need to be reinitiated with Form G—the Application form--and the conditions set under that form.

Certification Statement *

By submission of this form via the IMSI Admin website, the submitter:
• Certifies the accuracy of the information provided
• Understands that once returned, the IBN number may not be available for reassignment and the process will need to be reinitiated with a new application form.