To Whom It May Concern:
This Branded Calling Authorization form serves as verification that you would like to use Twilio to utilize your telephone numbers (“TNs”) for branding purposes. All TNs you will register for the Branded Calling service have been directly assigned to you from Twilio. By signing this form, you confirm that you have the authority to register the numbers you submit for branded calling purposes.
You are registering for the following display name and business. You are confirming that you have the authority and intellectual property to use the name and respective logo for branded calling. This authorization form is signed by an individual who affirms they have the authority to sign agreements on behalf of your organization.
| Display Name | Leonard “Lenny” Burton, CLU |
| Legal Business Name | Leonard Burton, CLU |
| Contact Name | Leonard Burton |
| Contact Email | ahoy@coveragecaptain.insure |
| Contact Job Title | Owner/Agent |
| Physical Service Address | 672 NE Bent Paddle Ln, Port St Lucie, FL 34983 |
| Current Telecommunications Provider | Twilio |
Yes, I authorize Twilio as the entity that has the right to use the numbers I submit digitally as part of my branded calling registration
By signing below, I authorize Twilio and their designated partner agents to validate, vet, and verify my organization. I understand that the use of the Branded Calling service will be limited to the authorized and approved TNs.