AMCP/AIC/08

CHANGE IN MOBILE PHONE NUMBER

Full Name (As in NRIC/Passport): ……………………………………………..

NRIC:
Correspondence Address:
Tel. No.:
Direct Upline’s Name:
Direct Upline’s Mobile Phone No.:
……………………………………………..
……………………………………………..
……………………………………………..
……………………………………………..
(O) …………………. (H) ………………
……………………………………………..
……………………………………………..

Current Mobile Phone No.: ……………………………………………..

New Mobile Phone No.: ……………………………………………..

Balance In Prepaid Account:

2 to 19 PP 40 to 59 PP 80 to 99 PP

20 to 39 PP 60 to 79 PP 100 PP and above

Signature of Mobile Agent: Date:

………………………………. …………………..

Note: Please be informed that MyMode will automatically deduct 2 PP from your prepaid
account as service charge. All changes in mobile phone number will have to be
forwarded with the mobile phone owner’s photocopy of NRIC. Agents are strictly
FORBIDDEN from reporting change in mobile phone number on behalf of others.

FOR OFFICE USE

Checked by:

………………………….
Name:
Date: