Requester Information We will interact with the requester throughout the porting process and contact them if we have any questions. Full Name*Customer Status*I am a current WestFax customerI need to set up an account with WestFaxRequester Email* Phone*Current Carrier Information Please make sure to fill in the following information exactly as it is displayed on your current telephone bill. Inaccurate information may result in a delayed or rejected port request.Current Carrier Name*Account Holder Name*Authorized Person on the Account*Account Number*Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Fax Numbers to Port (one number per line)* Billing Telephone Number*Notes and Special Instructions (Optional)Upload a copy of your billing statement(Optional) Drop files here or Accepted file types: pdf, png, jpg, docx. * I have read and agreed to the Letter of Agency * I certify that I am, or represent, the above named service customer, and am authorized to change the carrier for the listed fax number(s). CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.