The Subscriber requests the X. Y. Telephone Company (hereinafter styled the Company) to install and maintain at--------- a telephone on copper metallic circuit --------- [with not exceeding --------- other telephones on the same line], connecting it with the Company's --------- Exchange, and furnish exchange service to the Subscriber, his agents or employes, only, for one year from the date of installation and thereafter until this contract is terminated as provided hereinafter; and agrees to pay for the use and maintenance of the same and exchange service with the following exchanges, to wit: ---------, for each year $---------, payable quarterly in advance, and for all messages to points other than the foregoing exchanges, such tolls as are now or may be hereafter established; bills for such messages to be payable monthly on the --------- day of each month for the messages of the preceding month.

For the purpose of furnishing telephone service, the Company acts as the agent of the user of the telephone, and in view of the liability to errors incident to transmitting oral messages by telephone and the impossibility of fairly fixing the cause thereof, the Subscriber assumes all risks of errors arising from non-connections, mis-connections, and mistakes of servants and employes in transmitting, receiving or delivering messages.

Interruptions in service arising from causes other than the negligent or willful interference of the Subscriber shall be rebated pro rata for the time, after receipt of written notice, which such interruption shall continue, exceeding twenty-four hours, and such rebate shall constitute the only liability of the Company resulting therefrom.

Within a reasonable time after receipt of written order, and at the expense of the Subscriber, the Company will move the telephone and other equipment from place to place to any convenient point within the limits of the zone of exchange service hereinbefore described, where such removal does not involve change in the character of service or the terms hereof, and this contract continues binding, after any such removal, at new location.

Either party may terminate this contract at the expiration of the period above named upon giving ten - (10) days' written notice to the other of its intention so to do, otherwise this contract will renew itself thereafter quarterly until receipt of such notice, and when so terminated the Company shall be entitled to payments pro rata to the date of termination only.

Non-payment of rental or tolls when due as herein provided, violation of any of the provisions hereof, misuse of the property installed, the persistent use of said telephone in a way calculated to annoy other subscribers or the attachment by the Subscriber of any instrument or appliances to lines or telephones, without the consent of the company, will justify the termination of this contract by the Company and the removal of the instrument and fixtures from the premises of the Subscriber.

The telephone and other appliances furnished to be and remain the property of the Company, whose employes shall be permitted to enter the premises where the telephone may be located for the purpose of installing, inspecting, repairing, or removing the same.

This application becomes a binding contract upon its acceptance in writing by the Company and none of the terms hereof can be changed or waived by the representations or promises of any solicitor or other person, except in writing and signed by the general manager of the Company.

---------, Subscriber.

Witness ---------.

Accepted: The X. Y. Telephone Company, By ---------.