Multiline Internet Customer authority form

CUSTOMER AUTHORITY TO CHANGE TELEPHONE COMPANY FOR LOCAL AND / OR LONG DISTANCE AND BROADBAND

 

 

Phone Services To Be Changed/Ported -MANDATORY if porting and will hold upapplication if incomplete.
Current Telephone Number Current Local Call Provider Current Local Provider Account Number
     

 

 [   ]   PORT / TRANSFER EXISTING TELEPHONE SERVICE                     (CSG is not applicable) see note below for CSG details.

 

 [   ]  NEW CONNECTION &  NUMBER(waive my install CSG - saving of $100     on connection)  [   ]  NEW CONNECTION & NUMBER

        (Retain my install CSG)

 

CHANGE MY LONG DISTANCE PRE-SELECTION TO THE FOLLOWING PROVIDER:
[  ] MULTILINE [  ] TELSTRA (Additional Charges Apply) [  ] AAPT (Additional Charges Apply
CHANGE MY BROADBAND TO THE FOLLOWING PROVIDER:
[  ]  MULTILINE

 

CUSTOMER REQUESTED DATE (CRD):                                       Date         [   ][   ] / [   ][   ] / [   ][   ][   ][   ]

 

 

The above date is the date you would like to have your service transferred. Please not that where the nominated date is earlier than the minimum required time
the CRD will automatically be re-set to the minimum required time.

 

PLEASE READ AND SIGN BELOW

I hereby certify that as the lessee of the above services, or as an authorized representative (where applicable) that I have

authority and request to port, acquire a new service, churn my telephone and/or broadband service or select a long distance 

provider. I  acknowledge that the services will be carried over the networks of 1990 Multiline BBS Pty Ltd and Singapore

Telecommunications Ltd (Optus). I further certify and understand the following: 

 

 

1. I will relinquish any contractual rights with my current service provider, including, but not limited to discount plans. 

 

2. Some functions and facilities that are available through your current service provider may not be available from your new service provider. 

 

3. When porting your service from your current telephone or broadband (DSL) provider to your new service provider this may result in 

finalisation of your account for those services and though you have the right to Port your service, you are aware that there may be early termination charges and porting fees. 

 

4. Queries in relation to faults or service provision must be directed to your current service provider until the transfer is affected. 

 

5. In relation to my long distance selection above, I understand that if I have not selected a provider that it will default to

1990 Multiline BBS  Pty Ltd and Singapore Telecommunications Ltd (Optus). 

 

6. This Customer Authorisation is valid for 30 days from the date of signing, for a ULLS Port, however I understand that if needed I authorise the Authority to be automatically extended by a further 30 days. An authorisation for change of Long Distance Pre­Selection is valid for 30 days, however I understand that if needed I authorise the Authority to be automatically extended by a further 60 days.  A Local Call Churn and Broadband Churn authority is valid for 30 days.

 

I confirm that I am over 18 years of age, and are the legal entity authorised to sign the application for services.

 

 

 

Signed______________________________________________              Date___________________________________