MOBILE SERVICE SUBSCRIPTION RENEWAL FORM

Globe myBusiness (Small and Medium Business)

ACCOUNT DETAILS DELIVERY INSTRUCTIONS

Company Subsidized Account/ Sole Proprietorship Company Managed Account

Date: Email Address of Customer:

Customer Name/SPOC Name: Delivery Address:

Business/Company Name: Special Instructions:

Account Number: Billing Email Address:

ORDER DETAILS
Account Number Mobile Number/ Preferred Device Preferred Plan Plan MSF Lock Up Cash Out Amount List of Consumables List of Boosters Total MSF Others Duo Area
Net Service ID Period

10

TERMS AND CONDITIONS

1) Customer confirms the accuracy of the details stated above.
2) For Company Subsidized account, Customer further confirms that he/she is an employee of the Company named above. Should he/she cease to be connected with the Company, Globe shall immediately be informed of such fact by Customer.

3) By renewing the mobile service subscription, Customer agrees to be bound by the provisions of the Mobile Service Agreement (MSA) which can be accessed at http://mybusiness.globe.com.ph/MSA.
4) In addition to the provisions of the MSA, Customer agrees -
(a) to receive billing statement through e-mail; for Company Subsidized Account, to pay the Php50 monthly charge if Customer opts to receive paper bills; and
5) Customer hereby gives its consent for Globe to use Customer’s information in whatever lawful way Globe may deem proper including sharing it with Globe's affiliates, service providers and reputable companies whose products and services may interest the Customer.

Authorized Representative (signature over printed name)

__________________________________________
Customer Name or Authorized Signatory Name
Signature over printed name
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