Securus Form – Fill Out and Use

Dropped Call Investigation Form

Investigation Form for dropped calls billed by Securus Correctional Billing Services (SCBS)

I _________________________________ (Print Full Name), am the customer of record and party responsible for telephone service

______________________ (Telephone Number) located at _____________________________________________________ (Complete Address).

Dropped call disputes must be submitted within 90 days of the date of the call in order to be eligible to receive a call credit. I hereby am that the following calls initiated in the last 90 days were disconnected prematurely before I or the other party completed the collect call. I am disputing the following calls billed to my above referenced telephone account:

Date:______________ Time:_____________ From: _________________

Date:______________ Time:_____________ From: _________________

Date:______________ Time:_____________ From: _________________

Please note that Securus is not responsible for the transmission quality of wireless/cellular networks. These networks experience dropped calls. Therefore, Securus cannot issue credits for dropped calls to cell phones or wireless devices.

This document authorizes SCBS to conduct a complete investigation to determine why these calls terminated. I understand that in order to fully investigate this matter, SCBS may access call records, call recordings or other records pertaining to my telephone account, and I authorize SCBS this access.

SCBS will solely credit calls placed to landline numbers if the calls terminated for reasons SCBS is able to verify. Calls are verio determine reason for

disconnect. Calls will not be credted if any of the following occurred:
__ Calls to cell phones or wireless devices	__ Calls over 90 days old
__ Calls terminated for fraud attempts	__ Calls dropped due to 3-way calling attempts
__ Calls dropped due to call transfer/call forward attempt	__ Calls placed on hold by called party
__ Calls placed to cordless or speaker phones	__ Calls interrupted by using/answering call waiting
__ Calls dropped due to line silence (stopping or pausing)	__ Calls dropped due to dialing of additional digits on phone keypad (DTMF)

When SCBS has completed their investigation, my account will be updated with actions taken to address these disputes. The investigation could take up to 30 days to complete upon receipt of form. I understand and agree that completing this form does not absolve me from esponsibility

should the above call charges be sustained at the completion of the investigation. This form provides the authorization for SCBS to research and investigate the calls listed above. If SCBS determines that the calls under investigation were terminated due to either party disconnecting the call, I understand I will be responsible for the call charges. If SCBS determines the calls

were prematurely disconnected at no fault of either party, adjustments will be made to my telephone account.

Customer of Record Printed Name: _______________________________

Customer of Record Signature: _______________________________

Date: _______________________________

Please return form:

By Fax: 972-277-0714

By Mail: Securus Correctional Billing Services, PO BOX 1109 , Addison TX 75001

By Email: customer_service@securustech.net

For investigation results, call 800-844-6591

Securus Correctional Billing Services is a division of Securus Technologies, Inc and T-Netix Telecommunications Services, Inc.

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