APPLICATION FOR STARHUB SERVICE Service Application: Recontract Mobile Service CUSTOMER INFORMATION Name (as in NRIC/Passport/FIN): Document Type: NRIC/Passport/FIN: Nationality: Miss Ganendran Vasumathy NRIC S7179370B Singaporean Date of Birth: 21 Feb 1971 Contact Numbers (Home, Office, Mobile): 64811398, 64833968, 98516089 Email: vasuganen@yahoo.com.sg BILLING INFORMATION Billing Account No.: 1.11832268 Billing Address: 500 SERANGOON NORTH AVENUE 4 #10-518 550500 Bill Delivery Mode: STARHUB MOBILE (POSTPAID SERVICE) SUBSCRIPTION SERVICE Promotion Name Existing Plan Type Price Plan 4G 4 Existing Price Plan Hard Copy 24 Months iphone Mobile Voice Standard Promotion Standalone SmartSurf Lite Mobile Number 98560673 Monthly Charge $ 58.78 One Time Charge $ 0.00 SIM Serial Number - Value-Added Service(s) / Promotion(s) One Time Charge Monthly Recurring Charge Call Barring $ 0.00 $ 0.00 Call Divert $ 0.00 $ 0.00 Call Hold $ 0.00 $ 0.00 Call Tones $ 0.00 $ 0.00 Call Waiting $ 0.00 $ 0.00 Caller Number Display $ 0.00 $ 5.00 Free MaxMobile Access $ 0.00 $ 0.00 GSM Operator Barring $ 0.00 $ 0.00 HD Voice Plus $ 0.00 $ 0.00 Multi-Party Call $ 0.00 $ 0.00 Pay As You Roam $ 0.00 $ 0.00 SMS (Receive) $ 0.00 $ 0.00 SMS (Send) $ 0.00 $ 0.00 VideoCall $ 0.00 $ 0.00 Page 1
MOBILE SUBSCRIPTION Minimum Period of Service: Contract Period: 28 Jan 2015 to 27 Jan 2017 24 months (No downgrading of service during contract period) Tiered Promotion Early Termination Charge by Duration Month 1 2 3 4 5 6 7 8 9 10 11 12 Promotion Early 800.00 767.00 733.00 700.00 667.00 633.00 600.00 567.00 533.00 500.00 467.00 433.00 Termination Charge ($) Month 13 14 15 16 17 18 19 20 21 22 23 24 Promotion Early 400.00 367.00 333.00 300.00 267.00 233.00 200.00 167.00 133.00 100.00 67.00 33.00 Termination Charge ($) EQUIPMENT DETAILS Manufacturer: Model No: Apple IMEI: 356958068009215 EAPP0006803 IPHONE 6 GOLD 64GB PAYMENT SUMMARY Device: $ 305.00 SIM Activation Charge: $ 0.00 Deposit: $ 0.00 Early Recontract Charge: $ 0.00 TOTAL $ 305.00 Vouchers Redeemed $ 0.00 REMARKS device pice id $445 cust ack hange IT to pay as you roam no one to one exchange EXISTING PAYMENT MODE Existing Payment Mode: Cash Billing Account No.: 1.11832268 Bank Name: - I/We agree to the recurring payment mode arrangement tagged to the StarHub Account Number for this new service signup. Page 2
TERMS AND CONDITIONS - An early termination charge (as stated above) will apply if the StarHub service or any applicable value-added service(s) is terminated within the minimum period of service. - For SmartSurf HD Value, SmartSurf HD Plus and SmartSurf HD Premium customers, the 4G Speed Boost value-added service will be available free-of-charge until 31 December 2015. Thereafter, the prevailing charge of $10.70/month will apply. For the 4G Speed Boost value-added service, the speed is up to LTE 75Mbps. Details available at www.starhub.com/mobile. - For the 4G 3, 4G 4, 4G 5, 4G 6 and 4G 12 plans, we intend to increase the speed up to LTE 300Mbps by the end of 2014, without additional charge (from LTE 150Mpbs at launch). Whilst we will endeavour to do so, we are not obliged to provide such increase or to do so within the estimated timeline. - If you encounter any issues with the equipment, you are advised to visit the relevant manufacturer's service centre. Further details can be found on our website at http://www.starhub.com/content/support/general/visitus/listofservicecentres.html. - In the event of a return or exchange of the equipment, you are to return the full equipment (including the device, charger, battery, instructions and any other components and/or accessories) in the original packaging, accompanied by the original proof of purchase from StarHub. - Your use of the StarHub services and any value-added services is subject to StarHub's Consumer General Terms and Conditions, the Service Specific Terms and Conditions (including the terms and conditions herein and applicable promotional terms and conditions) and any other terms and conditions as may be agreed and accepted by you governing the services. The full terms and conditions are available at www.starhub.com. Page 3
PERSONAL DATA - By providing the information set out above, I/we consent to StarHub Ltd. and its related corporations (collectively, "StarHub"), as well as their respective representatives, agents and service providers, collecting, using or disclosing my/our personal data for purposes reasonably required by StarHub to provide the products and services which I am/ we are applying for, as set out in the StarHub Personal Data Protection Policy, which I/we have read and understood. Page 4
CUSTOMER'S ACKNOWLEDGEMENT I have read and fully understood the terms and conditions (as stated in the previous page) governing the StarHub service and the value-added service(s) elected and signed-up by me, and agree to be bound by them. I warrant and undertake that I am the duly authorised signatory of the named customer below. I confirm that I have provided full and accurate information to StarHub. I hereby acknowledge and agree that I have received the equipment purchased on Wednesday, 28 January 2015 in good working condition. Name of Customer (as in NRIC/Passport/FIN): NRIC/Passport/FIN: Miss Ganendran Vasumathy S7179370B Signature of Customer Date: 28 Jan 2015 11:58:23 FOR STARHUB USE Processed By: Courts-AMK Approval Code: - Sales Person Name: courtsamk@ideal Location: Courts - Ang Mo Kio Delivery Mode: Cash and Carry General Information - For after sales inquiry, please call our Customer Care Consultant at 1633 or +65 6820 1633 if you are calling from outside Singapore - Email us at customercare@starhub.com - Access our website at www.starhub.com - Visit our StarHub Shops - For sales inquiries, please call 1630 - For customer care inquiries, please call 1633 Page 5