Installation Address:

The landlord or owner of said property approves, permits and consents to the installation, maintenance, and removal of the BroadLink antenna, wireless modem and other equipment required for the indicated subscriber to receive BroadLink’s wireless services.

Your order will not be serviced until landlord permission is obtained. It is the Subscriber’s responsibility to obtain any required approvals or permits to gain landlords approval as disclosed for the placement of the antenna on the Subscriber’s building or residence.

PLEASE DO SO BELOW:

SUBSCRIBER NAME (print):  
SIGNATURE:  
   
LANDLORD/OWNER (print):  
SIGNATURE:  
DATE:  

Remit by mail or fax to:
BroadLink Communications
2260 Apollo Way
Santa Rosa, CA 95407-9112
Ph: 707-566-6300 Fax: 707-578-8520