Customer Profile Update Form

FRESHTEL INTERNET SDN BHD (1154469-D)

(Formerly known as Freshtel Group Sdn Bhd)
Lot 11, 2nd Floor, Millerz Square @ Old Klang Road, No. 357, Jalan Kelang
Lama, 57000 Kuala Lumpur.Customer Support: +603 9078 2963 |
Website: https://www.freshtel.my

SECTION A: CURRENT ACCOUNT DETAILS

Account Name Account Code

(As registered with Freshtel)
NRIC / Passport No.

Address

Postcode City
State

Telephone Number

Email Address

SECTION B: NEW ACCOUNT DETAILS

I request Freshtel Internet Sdn Bhd to change / update my account details given below against my aforementioned Account.

Account Name
(As registered with Freshtel)
NRIC / Passport No.

Address

Postcode City

State

Telephone Number

Email Address

SECTION E: CUSTOMER ACKNOWLEDGMENT

I hereby declare that details furnished above are true and correct. I understand Freshtel Internet Sdn Bhd reserves the right to verify any information
provided by me with regards to this application.

CUSTOMER SIGNATURE DATE OF APPLICATION

FOR FRESHTEL USE ONLY

CUSTOMER SUPPORT TECHNICAL SUPPORT BILLING SUPPORT

Received Date: Installation Date: Billing Start Date:

Remarks: Remarks: Remarks:

1 P a g e F R E S H T E L I N T E R N E T S D N B H D FT/FORM/2023/r.2