Residential Broadband

High-Rise Registration/Renewal/Upgrade Form

FRESHTEL INTERNET SDN BHD (1154469-D)
Lot 11, 2nd Floor, Millerz Square @ Old Klang Road, No. 357,
Jalan Kelang Lama, 57000 Kuala Lumpur.
Website:https://www.freshtel.my

SECTION A: APPLICATION TYPE

Please indicate where applicable:

🛈 Application Type: Registration Upgrade Renewal

SECTION B: SERVICE PLAN

Please indicate where applicable:

HFI connect
HFI connect
Bandwidth
No Contract 12 Months 24 Months
RM150 (refundable) + RM150 (installation)

50Mbps RM89 RM79 RM79 -

1st year RM99
100 Mbps RM99 RM99 **RM99 2nd year RM89
1st year RM129
200 Mbps - RM129 **RM129
2nd year RM119
1styear RM149
300 Mbps - RM149 **RM149 2ndd year RM139
1st year RM179
* 500Mbps - RM179 **RM179 2nd year RM169

Phone Line Yes / No

*500Mbps is available in certain location only **24 Months with Mesh Router *** All prices subject to 6% SST

SECTION C: PROMO CODE

Promo Code

SECTION D: DOCUMENT REQUIRED

Please indicate where applicable:

🛈 Provide a copy of: NRIC (Malaysian) Passport (non-Malaysian) / Deposit RM500

Bank Details: Hong Leong Bank Berhad / 236 0056 2859 - Freshtel Internet Sdn Bhd

SECTION E: CUSTOMER INFORMATION

Customer Name NRIC / Passport No.

Installation Address

Postcode City State

Telephone No Mobile No

Email Address

Agent Code(if any)

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 SECTION F: CUSTOMER ACKNOWLEDGMENT
I, NRIC / Passport Number hereby
accept any and all responsibility for the installation of Freshtel’s service and I understand and agree to accept and be bound by the terms and
conditions (https://www.freshtel.my) which accompany the usage of the Freshtel service. The terms and conditions are subject to change by
Freshtel Internet Sdn Bhd (Formerly known as Freshtel Group Sdn Bhd). I will be notified in a manner where necessary and appropriate. I
confirm that the information given herein is correct and accurate. I understand Freshtel reserves the right to verify any information provided
by me concerning this application.

Contract Period / Termination / Refund

The Service will continue automatically upon expiry of the Contract Period on a month to month basis unless otherwise terminated by me in
writing or official. The penalty will be charged if I Terminate the Service before the expiry of the Contract Period if any. Deposit refund (if any)
will be 45 working days after the termination date (last date of the service month) and after returning all the devices to Freshtel. Payment
advance (if any) only can be converted on last month usage. Refund will be returned to the account holder name only. If I fail to return the
equipment in a good working condition to Freshtel Internet's designated drop-off area upon the termination accepted, the Company has the
right to impose an RM400.00 fee to me as the compensation fee to the faulty or missing equipment.

Consent
In according to the Credit Reporting Agencies Act 2010 and Central Bank of Malaysia Act 2009, I/we the undersigned, do hereby irrevocably
and unconditionally give consent to you, your appointed registered credit reporting agency(ies) and/or any debts collecting agency(ies)
appointed by you to process my/our companies and personal data such as conducting credit/trade check, CTOS and DCHEQS checks on me/us
and where applicable, our director(s), shareholder(s), and guarantor(s) [collectively the "Parties"], with your appointed registered credit
reporting agency(ies) and/or debts collecting agency(ies) appointed by you at any time for as long as the Parties have a trade relationship with
you or where any dues remain unpaid and outstanding with you for the purposes of, (a) opening of the account; (b) debt recovery; (c)
credit/account review; (d) legal documentation consequent to a contract or facility granted by you; (e) credit/account monitoring and (f)
credit/account evaluation. You and/or your appointed debts collecting agency(ies) may disclose any information on the Parties conduct of their
accounts with you to any business entity(ies) for bona fide trade checking at any time. The Parties are also aware and understand that such
information will be provided to your credit reporting agency(ies) and/or debts collecting agency(ies), who may, in turn, share such information
to subscribers of their Service. Where you require any processing of our application to be processed by any processing centre located outside
Malaysia (including your Head Office), the Parties hereby give consent to your appointed registered credit reporting agency(ies) and/or debts
collecting agency(ies) to disclose their credit reports to such locations outside Malaysia. Apart from that, the Parties undersigned give my/our
consent to you and your appointed registered credit reporting agency(ies) and/or your debts collecting agency(ies), to process my/our personal
data as per the Personal Data Protection Act.

Service
I understand I am provisioned with high-speed internet access from my home, either with or without a voice service, based on the plan that I
have subscribed to in the registration form. I am aware that the package detail is available on https://portal.freshtel.my/plan-package-adviser;
Freshtel Internet may change the plans periodically, but such change does not change the Service I have subscribed. The Service is a personal
fixed high-speed internet access that enables me to access the world wide web and any offerings or services available thereon, but I will be
responsible for the risk whenever I am accessing these services. Freshtel Internet Sdn Bhd will provide me with a Service comprising standard
service components: an Optical Network Unit ("ONU") and a Wi-FI router. I understand Freshtel Internet Sdn Bhd aims to provide a continuous,
high-quality service using reasonable care and skill on a best efforts basis. However, I understand Freshtel Internet Sdn Bhd can't guarantee
that it'll be available all the time due to the nature of the Service and the Service Equipment Freshtel Internet Sdn Bhd uses to provide the
Services.

_
CUSTOMER SIGNATURE DATE OF APPLICATION

2 | Page FRESHTEL INTERNET SDN BHD FT/FORM/FHB21112023

 For FRESHTEL INTERNET INTERNAL USE

Assigned Account Code

Remarks:

Verification
Verified by: Verified Date: Completed

SECTION G: REFERRAL INFORMATION

Referral Name : Contact No:

ID Number / Acc. Code:

Referral Signature : Date :

Notes:
- One (1) Application is entitled to one (1) referral only
- Referral must have an existing account

FOR FRESHTEL USE ONLY

CUSTOMER SUPPORT TECHNICAL SUPPORT BILLING SUPPORT

Received Date: Installation Date: Billing Start Date:

Install By: Discount / Waiver:

Remarks: Remarks: Remarks:

3 | Page FRESHTEL INTERNET SDN BHD FT/FORM/FHB21112023