Form NS-65 "Hosted Voice Service (Hvs) Move/Change/Disconnect Order Form" - Louisiana

What Is Form NS-65?

This is a legal form that was released by the Louisiana Division of Administration - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2021;
  • The latest edition provided by the Louisiana Division of Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form NS-65 by clicking the link below or browse more documents and templates provided by the Louisiana Division of Administration.

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Download Form NS-65 "Hosted Voice Service (Hvs) Move/Change/Disconnect Order Form" - Louisiana

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Click for Instructions
Send
Louisiana Office of Technology Services Network Services
Hosted Voice Service (HVS) Move/Change/Disconnect Order Form (NS-65)
General Information
Date
Requested Due Date
GL Number
TC Submitting Request
Agency/ Division
TC's Telephone Number
Department
Order Type:
Move
Change
Disconnect
Order Information
Order Contact
Order Contact Telephone Number
Order Contact Email Address
User Information
User Name
User Telephone Number
User E-mail Address
Aastra/Mitel Device Type (Model Number)
Device MAC Address (back of phone)
Location Information
Existing Address/ Bldg/ Floor
New Address/Bldg/Floor
City
City
Zip Code
Zip Code
Room/Cubicle
Room/Cubicle
HVS Device/PC Jack ID Number
HVS/PC Jack ID Number
IT Information
Agency’s IT Contact Name
IT Contact Phone Number
Is there an active PC data jack for this user at the new location?
No***
Yes
Jack ID:
*** If No, check below to acknowledge. Complete an NS-25 Data Dial Tone Service Order Form and submit it to
doa-ots-lanet-
ddt@la.gov
to have the data port activated or a new jack installed.
TC Acknowledge
A Data Dial Tone Service Order Form will be submitted to OTS-NS for this user.
Note: See
http://www.doa.la.gov/Pages/ots/Telecommunications/Tele_Forms/Contents.aspx
for OTS Network Services forms.
Rev. 05/2021
Click for Instructions
Send
Louisiana Office of Technology Services Network Services
Hosted Voice Service (HVS) Move/Change/Disconnect Order Form (NS-65)
General Information
Date
Requested Due Date
GL Number
TC Submitting Request
Agency/ Division
TC's Telephone Number
Department
Order Type:
Move
Change
Disconnect
Order Information
Order Contact
Order Contact Telephone Number
Order Contact Email Address
User Information
User Name
User Telephone Number
User E-mail Address
Aastra/Mitel Device Type (Model Number)
Device MAC Address (back of phone)
Location Information
Existing Address/ Bldg/ Floor
New Address/Bldg/Floor
City
City
Zip Code
Zip Code
Room/Cubicle
Room/Cubicle
HVS Device/PC Jack ID Number
HVS/PC Jack ID Number
IT Information
Agency’s IT Contact Name
IT Contact Phone Number
Is there an active PC data jack for this user at the new location?
No***
Yes
Jack ID:
*** If No, check below to acknowledge. Complete an NS-25 Data Dial Tone Service Order Form and submit it to
doa-ots-lanet-
ddt@la.gov
to have the data port activated or a new jack installed.
TC Acknowledge
A Data Dial Tone Service Order Form will be submitted to OTS-NS for this user.
Note: See
http://www.doa.la.gov/Pages/ots/Telecommunications/Tele_Forms/Contents.aspx
for OTS Network Services forms.
Rev. 05/2021
Louisiana Office of Technology Services Network Services
Hosted Voice Service (HVS) Move/Change/Disconnect Order Form (NS-65)
Additional Information
Requested Features Changes/ Additions:
Additional Comments:
Use Acrobat Reader to open the form, then use the Send button above to submit online
OR email the completed form to NetworkOrders@la.gov
Rev. 05/2021
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