SMS Enablement & Consent Authorization

Business (brand) information

Legal business name *

DBA / brand name

Business type *

EIN / Tax ID *

Website

Business address *

Business email *

Business phone *

Authorized contact

Full name *

Title *

Email *

Phone *

Messaging use case

Number(s) to enable for texting *

Primary use case *

Describe the messages you'll send *

Sample message 1 *

Sample message 2

Expected monthly message volume

Customer opt-in (consent)

How do customers opt in to receive texts? *

Opt-in / opt-out handling

Authorization & signature

By signing below, I certify that I am authorized to act on behalf of the business named above, and I authorize Mutated Tech LLC to submit A2P 10DLC brand and campaign registrations to The Campaign Registry and the mobile carriers on our behalf using the information provided. I certify that the business will obtain prior express consent from recipients before sending messages, will provide clear opt-out instructions, will honor all opt-out requests promptly, and will comply with the Telephone Consumer Protection Act (TCPA) and CTIA messaging guidelines. I understand carrier approval is required and is not guaranteed, and that Mutated Tech does not provide legal advice.

Typed signature (full name) *

Title *

Date *

Questions before you sign? Call (615) 362-1023.

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Authorization submitted

Thanks — we've received your SMS enablement request and will begin the 10DLC registration. We'll reach out if the carriers need anything else.

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SMS enablement& consent.

Authorization submitted

SMS enablement
& consent.