CPNI Policy Please enable JavaScript in your browser to complete this form.DEAR CUSTOMER We value you as a customer and we know how much your privacy means to you. In the normal course of providing you telecommunication services, Wheat State Technologies collects and maintains certain information about you, whether it is the information actually contained on your monthly phone bill or information specific to your identity. Wheat State Technologies uses this information to conduct our business, to advise you of our products and services, and to provide you with excellent customer service. When you contact one of our customer CARE centers for assistance we will verify your identity prior to accessing your account information. This is to protect you and prevent fraudulent activity from occurring to your account. We will ask you to verify information that identifies you or the individuals you specify as authorized to view or make changes to your account. To begin this protection procedure we need you to specify whom in your household or family is authorized to add, delete, or otherwise make changes to your Wheat State Technologies accounts. We also need you to indicate a password that you and these individuals will use when contacting our company to verify their identities and your authorization to make changes. Account Holder InformationPrimary Account Holder Name *FirstLastSecondary/Joint Account Holder NameFirstLastPhone *Email *Authorized Person(s)I hereby permit Wheat State Technologies and its business associates to contact me or any other responsible party on my account, on our cell phones or other mobile devices, regarding any and all aspects of my account.Authorized Person (1)FirstLastAuthorized Person (2)FirstLastAuthorized Person (3)FirstLastIf someone requests a change and they are not on this list – or can’t share the password – we will not be able to fulfill the request. Account Password: *Choose a Security Question: *What was the name of your first pet?What was the name of your elementary school?What was the name of your high school mascot?What is your favorite color?What is your father’s middle name?What is your favorite football team?What was the last name of your favorite teacher?Who was the best man at your wedding?What is the name of your first grandchild?Who is your favorite Nascar driver?Answer to Security Question *e-SignaturePLEASE SIGN BELOW BY TYPING YOUR NAME: *Date *Submit