ZiaNet Customer Billing
   by Email.    (Click here for support by phone.)

This is a secure form. You may enter personal and financial information in this form with the confidence that the information will not leave the ZiaNet offices in transit. Use this form to change your phone number(s), billing address, Method of payment, or credit card information.

Change Information

Please provide the following information so that we may serve you promptly.

Customer ID:

 (This is a number in the upper right corner of your statement)

Your Name:

   Email address: 

Phone Number:

    For questions, you may call me from:   to  .

Please update my:

Phone Number(s)  §  Billing Address  §  Method of Payment  §  Credit Card information

Phone or Address Change

Please provide the following information so that we may serve you promptly.

New Phone(s):

Home:      Work: 

New Address:

  City:   State:    ZIP: 

Billing Method

Please provide the following information so that we may serve you promptly.

Current Billing:

 I am currently being billed by mail
 I am currently being billed by Credit Card

Please bill me by:

Credit Card  §  Mail  (Select one)

Billing Details

Please provide the following information so that we may serve you promptly.

Period:

 Bill me monthly by mail
 Bill me quarterly by mail
 Bill me annually by mail for a 10% discount.

Credit Card Information

Please provide the following information so that we may serve you promptly.

Period:

 Charge my Credit Card monthly
 Charge my Credit Card quarterly
 Charge my Credit Card annually for a 10% discount.

Credit Card:

Type:  Please Select Visa Mastercard Discover American Express

Number:   Expiration:  (MM/YYYY)

Full Name:

(as indicated on the Credit Card)

Address:

  City:    State:    ZIP: