Landlord Installation Approval Form Landlord Installation Approval Form Choose your situation* I am a Landlord I am a Tenant For Landlords/Property OwnersA tenant of yours has recently decided to sign up for Rise Broadband service. Their receipt of service from Rise Broadband is contingent upon obtaining a right of entry into the residence. By providing this signed form, you are granting Rise Broadband permission to install new service as the Landlord or Property Owner for this property. In addition, please remember that the Rise Broadband service is subject to availability and technical issues may still prevent installation of Rise service, such as a poor line-of-sight to the towers or inadequate signal strength. In which case, your tenant’s account will be cancelled and any pre-paid fees will be refunded to the tenant. We have also requested that your tenant make the appropriate accommodations for any pets or locked gates, as well as, ensuring any other individuals that need to know about the install are aware i.e. facilities and maintenance teams. Please complete the sections below:For Customers Renting or LeasingDear prospective Rise customer, Congratulations on your decision to sign up for Rise service! Your receipt of service from Rise Broadband is contingent upon obtaining a right of entry into your residence. If you do not own the residence in which you intend to install your Rise Broadband Service, we require that you obtain the landlord or Property Manager’s written approval prior to installation. Please be advised that Landlord/Property Owner approval is often required with multi-tenant apartment buildings and/or residences. By providing this signed form, you are granting Rise Broadband permission to install your new service at the property. If Landlord/Property Owner approval is not required, please sign and date below. This releases Rise Broadband from any liability related to damages your landlord may claim as a result of an alleged violation of your lease/rental agreement pertaining to this install. In addition, please remember that the Rise Broadband service is subject to availability and technical issues may still prevent installation of your Rise service, such as a poor line-of-sight to the towers or inadequate signal strength. In which case, your account will be cancelled and any pre-paid fees will be refunded. Also please make the appropriate accommodations for any pets or locked gates, as well as, ensuring any other individuals that need to know about the install are aware i.e. facilities and maintenance teams.Landlord / Property Owner InformationLandlord / Property Owner Name* First Last Landlord / Property Owner Phone*Landlord / Property Owner Email* Resident / Tenant InformationTenant / Resident Name* First Last Tenant / Resident Phone Number*Tenant / Resident Email* Service Address and InformationService Address*No P.O. Boxes Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Property NameIf applicableIf this is for a multi-dwelling unit/apartments, do you provide approval for the whole complex? Yes No Not Applicable Installation Agreement*By signing and completing this form, you verify permission has been granted to have holes drilled from the inside of the property to the outside to allow for a cable run as well as approve the mounting of the equipment on the roof. You also approve Rise Broadband Service technicians’ access to the equipment in the future if there is a need for maintenance or upgrades.EmailThis field is for validation purposes and should be left unchanged.