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Residential Telephone Application

Fill out the form below to apply for telecommunications services with Independence Light & Power. Please refer to www.ilpt.com for complete service descriptions and our terms of service. Contact us at (319) 332-0100 for additional information or if you have any questions. Thank you!

After submitting your application for telecommunications service you will be directed to review and consent to our Terms Of Service for Digital Phone Service.

Customer Information

First Name *

Last Name *

Date of Birth *

Month

Day

Year

Daytime Phone *

Cell Phone *

Email *

Co-applicant First Name

Co-applicant Last Name

Co-applicant Date of Birth

Month

Day

Year

Co-applicant Phone

Service Address

Street Address *

Address Line 2

City *

State

Zip Code *

Billing Address

Street Address

Address Line 2

City

State

Zip Code

Other Residents (over 18)

Telephone Services

*$29.95 install fee applies if you only subscribe to one service. Install fee is waived if you subscribe to two or more services.

Residential Rates

Telephone ONLY | $49.95

Bundle Cable OR Internet | $39.95

Bundle Cable AND Internet | $29.95

Local ONLY | $14.95

Local Rated | $14.95/.07 per minute

Optional Monthly Services

Directory non-published / non-listed | $4.95 + $8.95 set up

Directory non-published | $2.95 + $8.95 set up

Residential Wire Maintenance Fee | $2.95

New/Additional phone jacks | $24.95

How would you like your name in the directory?

Who is your current telephone provider?

Would you like to keep your current phone number?

Yes

If no, we will assign a new 332# or 938#

I would like voicemail

Yes

Voicemail doesn’t work with an answering machine.

If not a current utility customer, please complete

*Copy of photo ID required if not a current customer.

Photo ID

Upload picture via phone or scanned image.
Files must be less than 6 MB.
Allowed file types: gif jpg jpeg png pdf.

Applicant Current Employer

Applicant Employer's Phone

Employer's Street Address

Address Line 2

City

State

Zip Code

Supervisor's Name (First and Last)

Co-applicant's Current Employer

Co-applicant's Street Address

Address Line 2

City

State

Zip Code

Emergency Contact

Name

(First and Last)

Phone Number

Acknowledgement Of Terms

I have read and agree to all terms of service (available on www.ilpt.com or at Independence Light & Power, Telecommunications) that I have applied for on this application.

Consent *

Agree

Leave this field blank

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Independence Light & Power Telecommunications
700 7th Ave NE
Independence, IA 50644
(319) 332-0100
Hours: Monday-Friday 7:00 am – 4:00 pm