Payphone Service Provider Forms



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Payphone Service Request
RF-4133 (webform) RF-4133(pdf)
Credit Profile
RF-3950(doc)
Letter of Agency
RF-3973 (webform) RF-3973(pdf)
Authorization And Release Notice
RF-3916b (webform) RF-3916b(pdf)
Statement of Assumption Of All Outstanding and Future Charge
RF-3916a (webform)
PSPSC Master Log Sheet
RF-3638 (webform) RF-3638(pdf)
Authorization and Release of Telephone Number
RF-3619 (webform) RF-3619(pdf)
Surety Bond
RF-2354 (webform) RF-2354(pdf)
Missed Appointment Service Order Cancellation Notification
RF-2353 (webform) RF-2353(pdf)
TAPP Rejection List
RF-2352 (webform) RF-2352(pdf)
IPPS Work Request
RF-2349 (webform) RF-2349(pdf)
Payphone Store Access Request
RF-2346 (webform) RF-2346 (pdf)
Billing Adjustment Request (BAR Form # RF-1461)
This form may be printed and filled in by hand or electronically and faxed, mailed or e-mailed to BellSouth. (The preferred method of delivery is e-mail) Please email to: payphone.disputes@bellsouth.com
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Billing Adjustment Request Form (BAR) Field Descriptions
This document will assist users in filling out the BAR Form. It contains specifics of the field entries and user instructions.  word