Louisiana Office of Telecommunications Management
Web Billing Security Access Request Form
for Telecommunications Coordinators (OTM-26)
Yes
No Print and mail my OTM bill
I would like to have the capability to view and/or download my OTM bill
via the Internet
Yes
No
First name:
Last name:
Initial password:*
Email address:
Phone number:
Department/agency
name/description:
List ALL OTM Accounting Units/Cost Center numbers that you are authorized to view**
TC Signature
Date
* Passwords are alpha/numeric, case sensitive, and required to be from 6 to 20
positions long.
** Please check accounting unit/cost center numbers for accuracy and confirm with your
agency fiscal officer.
If you decide to download your bill from the Internet at a later
date and do not want OTM to print and mail it, you must notify
OTM by the 19 th of the month or you will continue to receive the
printed bill, and be charged $.75 per printed page.
Submit a separate form for each authorized TC
OTM-26 (09/06)
Fax the completed form to OTM at 225-342-7372.