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    melvin bautista
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    SMART FORM NEW

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    9 views4 pages

    Smart Form New

    Uploaded by

    melvin bautista

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 4
    Date of Application: on PERSONAL INFORMATION WHERE CAN WE CONTACT YOU: sul Name My contact deta shalba Used sujet tothe Subserber’s Decaato Office/Business Number E-mail Adrese Nickname Birthday Mobite Number Home Number In case we can't reach you who else can we contac for - applleation evaluation? Home Aaldress smplete Name Oo : WORK INFORMATION OficerBusiness Name office Gender Male IDNo, Length of Service with Current Employer/Business Citizenship Start Date of Employment/Susiness imm/ddiyyyy aan = : eee tara Outof-contract CO) tetyRatenion Remaiing Mons) eee ee Ue mmr ele Name of Subscriber Mobite No Consent to take photos O nwa Aecount No, Plan Description CConteac End Date Date Time smart Branch ouree of Application: (C) Inbound New Contract End Date Sales Representative’ Non 1 ee) \hertepitin ()Addoral ne PonRonnt (Mie sptcton Oye eeu dee 0@ 0@oW@ a — 12 months MSF PHP 599 PHP 999° PHP 1499 PHP 1999 PHP 2499 20GB 40GB 60GB UNLI Data 5GB UNLI 5G for 6 Months AG/SG Calls Unli AliNet** Mobile Calls and Landline Calls Texts Unli AliNet** Subscription Netflix Mobile Plan Signature Device Plans* Oe) @) C ae 24 months MSF PHP 599 PHP 999 PHP 1499 PHP 1999__| PHP.2999 Data 2.5GB sap | 10GB_—S«|~—s15Ga_ | s0aa_ | nn ge TT =e Eh one | aes [SO Unli AUNet** Mobile Calls Unti AllNet** ees Choose your Device Claiming Option 7) One-time Cash-out | (ep tom Ths Store Pickup trom Other Store Branch; rect Delivery (hipine Accra : ~) Device Amertizotion “Senate bert nyesin 4OATE powered oreo, and Sahat Mons 86 porre atest m9 Sa Sa-ertes pone ne: crn THT te /TA/ DTC ce aaa eae eee Chosen Plon Chosen Device | TOTAL MONTHLY FEE [ Commitment Period rome Availed ‘resent epretntti has shown me | Howes ) now toserupandusre Gout ape toimancge my Sra por ) Automate Debt Agreement (~) Ggotte Aap Tubacibers Name and Sgroare ‘Stream easy and charge your entertainment subscriptiomte your monthly bill) s ° fea soxty Mernosie/rieaipscse/ | HBOGO 1222 | ES spotity *ia spn rom ove eo Beale teeta Premium Que / PHP 214 Premium Family AUTOMATIC DEBIT AGREEMENT TERMS AND CONDITIONS 1 For purposes of thi Automatic Ded Agreement, the woxes oe" me" and "my”ahall reer te the Subscriber while the words you" and "your shall eferto Smatt Comm Inc (SMART 2. My enrollment to the Automatic Debit Agreement CADA'L shall take effect upon approval of the issuing bank or acquiring bank, and SMART. 5 Upan the approval of my enrollment to the ADA 1 hereby authorize SMART to automaticaly charge my total 2 balances to my enrolled credit card, on 3 monthly ba roudea in ne creditcard biling charge subi oy SMART tothe suing bank or acquiring bank rejected o deci for any teason whatsoever, SMART may stil atiemt 19 submit the same biling charge to the issuing b ‘euiring 63nk unbl the total accent balance for we next ning petiog becomes aviabl 4. Balances that are stil outstanding prior te my application tor fenraliment to the ADA may be charges by SMART to my {radit card upon approval of my ADA enrollment. In the event thatthe erealt card bing charge submitted by SMART to the issuing bank er acquiring bank Is rejected oF ecined for any reason or whatsoever, | shall Settle my futstanding balance drectly auth SMART or through 6. | understand that in case of changes in my credit card umber brought about by ca lost credit edrd. upgrade andlor cara renewal, 1 shall be red to submit'a new ADA Enrolment Form indieating jase changes | understand that in credit card expiry date, brought about by cases, uch as, but not ited to card renewal. shall be required to report the ew expny dite of my enrolled edit card to youre setvce, In case fal report the new credit cara expiry date ind my enrolled credit card is already expired, SMART shal feiteavor to ty t6 update the new expiry date to be able to continue the submigsion of my iting charge to the suing anv ortne acquinng bank Proved nowever that, shall Be nels abe for aay inconvenience or delay of my payments should the eregit card company cecine the tr tothe changes in my credit card number andar ‘expty date which ae not reported to you understand that in cate of changes in my mobile number or sccount umber brought about by cases, such as, Dut not lite to, change in ownership or account migration to or from any of the SMART Postpaid services, I shall be requires to submit a new ADA Enrollment Form indicating these changes, | understang that at any time, SMART may init ancellaton of my enrollment to the ADA, for any reason ‘cancellation for any reason whatsoever, | shall pay my tll ‘rectly to SMART or through SMART'S accredited payment channels Any amount due prior to the etfective Such cancellation shal stil be due and demandabie ard may stllbe submitted by SMART t0 the issuing bank of acquiting bank for aperoval prior to the effective cate af the ccanceliston 9 Hull understand that my ty account to exemptions from the p reabrection services even when my usage has exceeded the assigned credit limit for my account. understood and agrees to the Terms tions governing the Automatic Debit Agieement idenced by my nature inthis Applicaton Fenn (eee ent CARD HOLDER INFORMATION rege Cd Number cars Ey Oat SMART ACCOUNT INFORMATION ccourt Numbers) big erred AOAMandtay? TT O™ ore Cavaalcers grate over Datei Do ‘SUPPLEMENTAL TERMS TO THE AUTOMATIC DEBIT AGREEMENT “Thundering ory apteabihun aint tater Dei geen 2 Vien ry ewcliment'o Autorate Orb Agcemert 9 diaporoved by the Cea

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