Arbitration Opt Out Request Form

Please complete all blanks to submit your request to opt out of the arbitration process. If information is incomplete or inaccurate, your opt out request will not be valid. The information provided must be for the specific T-Mobile line of service, activated within the last 30 days, for which you want to opt out. Please note that this is a secure website.

Account Holder’s Name:
(You must be the account holder to submit an opt out request.)
First:  Last:

Billing address on account:
(Billing address for the line of service for which you want to opt out.)
Street Address:

City: State:  Zip:

Phone Number:
(Wireless phone number activated in the last 30 days for which you want to opt out of arbitration.)