Telemarketing Registration Application
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4COMMONWEALTH OF PENNSYLVANIA
OFFICE OF ATTORNEY GENERAL
Bureau of Consumer Protection
15th Floor Strawberry Square
Harrisburg, PA 17120
Phone: (717) 783-1992
Telemarketing Registration Application
PART I:
Identification
Name of Telemarketer
Location of Telemarketer (Preferred mailing address for notices? Yes
No)
City
State
Zip Code
County
Name of Corporation, LLC, Partnership or Individual Owner
Address (Preferred mailing address for notices? Yes
No)
City
State
Zip Code
County
Name of Contact Person
Fax Number
Telephone Number
Email Address
Name & Addresses of Registered Agent (If Owner is located outside of PA)
Current Registration Number (if
applicable)
This Form is (check one):
A registration for a new telemarketing entity not previously registered in PA
A change to the registered telemarketer’s ownership or address information
A change to a different Bond or Letter of Credit for a registered telemarketer
Other (please indicate):
Please submit the original copy of the bond or letter of credit.
Location(s) of Call Centers for calls placed to PA residents
Name
Address – Line 1
Address – Line 2
City
State
Zip Code
Name
Address – Line 1
Address – Line 2
City
State
Zip Code
Name
Address – Line 1
Address – Line 2
City
State
Zip Code
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Parent category: Business