Step 2 - Your Information

Please complete form carefully.

Name (First M. Last)
Address (123 Main St, Apt#)
City
State	Select from this List Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming ------
Zip
Phone (321-456-7890)
State of Incarceration	Select from this List Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming ------

How long have you been accepting phone calls from someone in prison?
(Enter number in years. If less than a year, please enter "1")

Date you sent complaint letter to phone company
(MM/DD/YYYY)

Complaint Classification
	Service Issue (premature disconnects; denial of access to reasonably priced services)
	Credit or Billing Dispute (charged for calls when not at home; blocking calls to force prepayment; no accounting for charges covered by prepayment)

On the lists below, please check the problems you have encountered with
the prison telephone system in your state. Use the "other" option to briefly
describe any solution not listed.

I have encountered the following service problems:
	I have had calls prematurely terminated. Since there is a substantial surcharge for the first minute of the call, this practice is costly for me.
	I have had my phone number blocked, apparently because the prison phone service provider does not have a billing agreement with my local phone company.
	I am routinely denied access to less expensive telephone service, being forced instead to use only collect calls. There is no legitimate rationale for this restriction.
I object to the charges I am being asked to pay:
	I have been charged for calls that I was not home to receive.
	I am charged exorbitant rates, in part because the prison phone service provider offers your state an unreasonably high commission.
	I am forced to pay in advance for collect phone calls, and never receive an accounting of dates, times, and length of calls charged against that prepayment.

Tell us what other problems you've experienced:



On the list below, please select the solutions you would consider acceptable.
Use the "other" option to briefly describe any solution not listed.

	Cease charging for calls I am not home to receive.
	Cease premature terminations.
	Remove the block on my phone.
	Charge rates that are sufficient to cover only the cost of operating and managing the system, plus a reasonable profit for the phone company.
	Introduce less expensive calling options, such as debit calling.

Other Solutions:


Please note that you may want to send a copy of a typical phone bill with your complaint.


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