Prepaid - Dealer Submission

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Gen Door Submission

Is this submission an door ownership change?

(If yes) Original Gen ID

(If yes) Original Door Name

Lead Source*

Door Type*

Boost Lead Number

TSP*

TSP Terminal ID

ePay Account ID

Boost Portal ID

Master Agent*

Master Agent Email*

DDP Representative

Store Name*

Store Owner Name (First and Last)*

Store Owner Phone*

Store Owner Email*

Store Street*

Store Unit

Store City*

Store Zip Code*

Store State*

Store Country*

* Gen Mobile offers nationwide 5G/4G LTE services on the nation's largest 5G GSM network. Our 5G GSM network is expanding and already covers close to 250 million Americans in more than 7,500 cities nationwide. No 5G signal goes farther or is more reliable indoors and out.

† To get 4G LTE speed, you must have a 4G LTE capable device and SIM. To get 5G coverage, you must have a 5G capable device and SIM. Actual availability, coverage, and speed may vary. LTE is a trademark of ETSI.

¹ Our 15 day text freebie only includes individual SMS texts (no MMS, including images, videos, and group messages).

² $39 activation fee is applicable to all plans.